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Yakut I, Pamuk FÖ, Arslan K, Ozdemir C, Kara M, Korkmaz A, Deveci B, Ozeke O, Cay S, Ozcan F, Aras D, Topaloglu S. Accessory Pathway in Ebstein's Anomaly: Absence of Evidence Is Not Evidence of Absence. J Innov Card Rhythm Manag 2022; 13:4905-4907. [PMID: 35317209 PMCID: PMC8930009 DOI: 10.19102/icrm.2022.130304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/27/2021] [Indexed: 11/06/2022] Open
Abstract
Electrocardiography has certainly great merit and is almost abnormal in most patients with Ebstein's anomaly. Incomplete or complete right bundle brunch block (RBBB) is seen in almost half of these patients. The absence of the expected RBBB during sinus rhythm in a patient with Ebstein's anomaly is a useful clue of pre-excitation in these patients.
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Affiliation(s)
- Idris Yakut
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Funda Özlem Pamuk
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Koray Arslan
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ceren Ozdemir
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Meryem Kara
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ahmet Korkmaz
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Bulent Deveci
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Ozcan Ozeke
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey,Address correspondence to: Ozcan Ozeke, MD, Sağlık Bilimleri Üniversitesi, Ankara Şehir Hastanesi, Kardiyoloji Klinigi, Bilkent, 06800, Ankara, Turkey.
| | - Serkan Cay
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Firat Ozcan
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Dursun Aras
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Serkan Topaloglu
- Department of Cardiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Saoussen A, Sana O, Kaouther H, Hela M, Fatma O. Electocardiographic features in Ebstein's disease. LA TUNISIE MEDICALE 2021; 99:614-622. [PMID: 35244913 PMCID: PMC8795996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Ebstein's disease (ED) is a rare and heterogeneous congenital heart disease affecting the tricuspid valve and the right ventricle. Few studies have analyzed the electrocardiographic features of this disease. AIM To describe the electrocardiographic features observed in Ebstein's disease. METHODS We conducted a retrospective descriptive study that enrolled 26 patients followed for ED. RESULTS The mean age of discovery of the ME was 103.5±99 months [0-31 years]. The diagnosis of ME is most often made between 5 and 10 years. We noted right atrial hypertrophy in 11 patients (42%), right ventricular hypertrophy in half of the patients. Right axial deviation was noted in 11 patients (42%). Eight patients (30%) had wide QRS≥ 120 ms. Seven of these 8 patients (27%) had a fragmented QRS appearance. A right bandle block was noted in 22 patients (84%), it was a complete block in 7 cases (27%). A preexcitation was found in 6 patients (23%). The localization of accessory pathway was right postero-septal in all cases. Rhythmic disorders were noted in 9 patients (34%). It was a junctional tachycardia in 3 patients (11%), atrial flutter in 4 patients (15%) and atrial fibrillation in 2 patients (7%). A second degree atriventricular block was observed in one patient, it was Mobitz I type. Two cases of postoperative rhythm disturbances were recorded: paroxysmal atrial fibrillation and junctional tachycardia related to Wolf Parkinson White (WPW) syndrome. CONCLUSION Surface ECG in the ED is often pathological with prevalence of rhythm disturbances related to WPW syndrome.
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Dalakoti M, Singh D, Yeo WT, Tay LWE, Poh KK. Electrocardiography findings and clinical presentation in Ebstein's anomaly. Singapore Med J 2019; 60:560-564. [PMID: 31781776 DOI: 10.11622/smedj.2019146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ebstein's anomaly is a congenital malformation characterised by tricuspid valve pathology with right heart enlargement. Cases of Ebstein's anomaly can vary widely in severity, anatomy and presentation. In this article, we presented three cases of Ebstein's anomaly and discussed the presentation as well as electrocardiographic (ECG) changes. Patients may first present to their primary care physicians with cardiac symptoms such as reduced effort tolerance together with an abnormal ECG. ECG changes suggestive of right heart enlargement are important in the initial consideration and eventual formal diagnosis of the condition.
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Affiliation(s)
- Mayank Dalakoti
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Devinder Singh
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wee Tiong Yeo
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lik Wui Edgar Tay
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore.,NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Pérez-Riera AR, Barbosa-Barros R, Daminello-Raimundo R, de Abreu LC, Nikus K. Electro-vectorcardiographic and electrophysiological aspects of Ebstein's anomaly. Ann Noninvasive Electrocardiol 2018; 24:e12590. [PMID: 30106198 DOI: 10.1111/anec.12590] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 06/17/2018] [Accepted: 07/25/2018] [Indexed: 11/26/2022] Open
Abstract
Ebstein's anomaly is a congenital heart disease where the most important anatomic feature is the inferior displacement of the tricuspid valve leaflets. Vectorcardiographic features are mainly forgotten and electrocardiographic features may be unrecognized by cardiologists handling adult patients.
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Affiliation(s)
- Andrés Ricardo Pérez-Riera
- Design of Studies and Scientific Writing Laboratory in the ABC School of Medicine, Santo Andre, Sao Paulo, Brazil
| | - Raimundo Barbosa-Barros
- Coronary Center of the Messejana Hospital Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceara, Brazil
| | - Rodrigo Daminello-Raimundo
- Design of Studies and Scientific Writing Laboratory in the ABC School of Medicine, Santo Andre, Sao Paulo, Brazil
| | - Luiz Carlos de Abreu
- Design of Studies and Scientific Writing Laboratory in the ABC School of Medicine, Santo Andre, Sao Paulo, Brazil
| | - Kjell Nikus
- Heart Center, Faculty of Medicine and Life Sciences, Tampere University Hospital, University of Tampere, Tampere, Finland
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