title: Absent right bundle branch block: Is it a clue of pre-excitation in Ebstein's anomaly?
abstract: A 14-year-old male with a history of symptomatic tachycardia was referred for ablation. Sinus rhythm electrocardiogram was not showing any pre-excitation. Tachycardia episode was showing antidromic tachycardia with left bundle branch block morphology. Echocardiographic examination was showing Ebstein's anomaly with septal tricuspid leaflet displaced 24mm apically. The right bundle branch block (RBBB) was concealed during sinus rhythm. The RBBB was revealed with ablation of right posterior atriofascicular accessory pathway.
authors.affiliation: Senior Resident, Department of Cardiology, LTMMC and LTMGH, Sion, Mumbai 400022, India. Electronic address: pranil.bjmc@gmail.com.
authors.forename: Pranil Bhalchandra
authors.initials: PB
authors.lastname: Gangurde
authors.affiliation: SMO, Department of Cardiology, LTMMC and LTMGH, Sion, Mumbai, India.
authors.forename: Abhay
authors.initials: A
authors.lastname: Tidake
authors.affiliation: Associate Professor, Department of Cardiology, LTMMC and LTMGH, Sion, Mumbai, India.
authors.forename: Hetan
authors.initials: H
authors.lastname: Shah
authors.affiliation: Professor, Department of Cardiology, LTMMC and LTMGH, Sion, Mumbai, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Mahajan
authors.affiliation: Department of Cardiology, LTMMC and LTMGH, Sion, Mumbai, India.
authors.forename: Yash
authors.initials: Y
authors.lastname: Lokhandwala
authors.affiliation: Professor and Head of Department, Department of Cardiology, LTMMC and LTMGH, Sion, Mumbai, India.
authors.forename: Pratap
authors.initials: P
authors.lastname: Nathani
mesh_terms: D000293:Adolescent; D002036:Bundle of His / Q000503:physiopathology* / Q000601:surgery; D002037:Bundle-Branch Block / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D017115:Catheter Ablation; D004437:Ebstein Anomaly / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D004452:Echocardiography; D004562:Electrocardiography; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male
keywords: Antidromic tachycardia; Dynamic; Ebsteins anomaly