Ebstein's anomaly with refractory atrial tachycardia

The incidence of accessory pathways in patients with Ebstein's anomaly is high, ranging from 20% to 30%, with right and multiple pathways being more commonly encountered. Radiofrequency ablation can eliminate the accessory pathway, but success rates of ablation treatment and the chances of recurrence are generally less satisfactory as compared to those observed when the procedure is performed on structurally normal hearts. We report the case of a 56-year-old man with Ebstein's anomaly and refractory atrial tachycardia. The special abnormality of the tricuspid valve led to the failure of preoperative electrophysiological mapping and radiofrequency ablation treatment. Finally, the anomalies observed in this patient were corrected with simultaneous surgery and pathway resection.