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Wide complex tachycardia in an elderly woman due to Ebstein’s anomaly with two accessory pathways  Vlad Radulescu, MD, Joseph Donnelly, MD, Jonathan Willner,

Published byLudwik Pawlik Modified over 6 years ago

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Presentation on theme: "Wide complex tachycardia in an elderly woman due to Ebstein’s anomaly with two accessory pathways  Vlad Radulescu, MD, Joseph Donnelly, MD, Jonathan Willner,"— Presentation transcript:

1 Wide complex tachycardia in an elderly woman due to Ebstein’s anomaly with two accessory pathways 
Vlad Radulescu, MD, Joseph Donnelly, MD, Jonathan Willner, MD, Stuart Beldner, MD, Apoor Patel, MD, FHRS, Shahryar G. Saba, MD  HeartRhythm Case Reports  Volume 5, Issue 4, Pages (April 2019) DOI: /j.hrcr Copyright © Terms and Conditions

2 Figure 1 A: Presenting electrocardiogram (ECG). B: ECG post cardioversion showing delta wave and short PR interval. HeartRhythm Case Reports 2019 5, DOI: ( /j.hrcr ) Copyright © Terms and Conditions

3 Figure 2 A: Transthoracic echocardiogram right ventricular inflow view demonstrates apical displacement of the posterior tricuspid valve leaflet (white arrow). The red arrow marks the anterior tricuspid valve leaflet. The area between the visualized tricuspid valve leaflets and the coronary sinus (CS) represents atrialized right ventricle (RV). B: Color flow Doppler in the same plane shows a jet of tricuspid regurgitation. C, D: Cardiac computed tomography in the short-axis view at the basal (C) and mid (D) ventricular levels shows the anterior (red arrow), septal (blue arrow), and posterior (white arrow) tricuspid valve leaflets. E, F: The 4-chamber view demonstrates a 12-mm and 26-mm displacement of the septal (E) and posterior (F) tricuspid valve leaflets, respectively, from the anterior mitral valve leaflet insertion. Red, blue, and white arrows mark the same tricuspid valve leaflet (anterior, septal, or posterior) throughout the figure. IVC = inferior vena cava; RA = right atrium; RV = right ventricle. HeartRhythm Case Reports 2019 5, DOI: ( /j.hrcr ) Copyright © Terms and Conditions

4 Figure 3 A: Electroanatomic mapping in left anterior oblique view of right atrium. Yellow tags indicate location of His potentials. Two sites of accessory pathways are noted by red tags. B: Surface electrocardiogram (ECG) and local electrograms at site of posterolateral pathway before (Pre) and after (Post) ablation. C: Surface ECG and local electrograms at site of posteroseptal pathway before (Pre) and after (Post) ablation. D: Surface ECG at end of case. (Speed: 25 mm/s.) Note loss of pre-excitation. AP = anteroposterior; L = left; R = right. HeartRhythm Case Reports 2019 5, DOI: ( /j.hrcr ) Copyright © Terms and Conditions

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