Cardiology

Examination of pathological features of the right atrioventricular groove in hearts with Ebstein's anomaly, and correlation with arrhythmias.



Related Articles

Examination of pathological features of the right atrioventricular groove in hearts with Ebstein’s anomaly, and correlation with arrhythmias.

Heart Rhythm. 2020 Jan 21;:

Authors: Marcondes L, Sanders SP, Del Nido PJ, Walsh EP

Abstract
BACKGROUND: Catheter ablation of accessory pathways (AP) in Ebstein’s anomaly (EA) has a higher recurrence rate than in normal hearts. Anatomic features could account for suboptimal ablation outcomes.
OBJECTIVES: Examine right atrioventricular (AV) groove in autopsy hearts with EA, correlate with clinical data, and identify features relevant for catheter ablation.
METHODS: Thirty three specimens with EA were examined from our Cardiac Registry. The right AV groove was inspected for gross anatomic features. Limited microscopy was performed on selected specimens. Pre-mortem clinical data were correlated with anatomical findings.
RESULTS: A prominent ridge along the right AV groove was seen in 15/33 specimens (45%). Ten specimens had a clinical history of AP (AP+). The extent of ventricular atrialization did not differ between AP+ and AP- groups (64 ± 63mm/m2 vs 76 ± 42mm/m2, p=0.61), nor did the presence of visible macroscopic AV tissue connections (45% vs 51%, p=0.68). The single item that differed was the presence of an AV groove ridge itself, which was significantly more common in the AP+ group (70% vs 21%, p=0.03). Microscopy of ridge tissue revealed a muscular bundle in one AP+ specimen penetrating deep into the fibrous AV annulus that was suggestive of an AP, although complete muscular continuity was not verified in the limited sections available for examination.
CONCLUSIONS: A prominent ridge along the inferior right AV groove is a common feature in EA, and correlates with clinical history of AP. It presents a potential obstacle to catheter ablation, and may contribute to recurrence rate.

PMID: 31978592 [PubMed – as supplied by publisher]

Source link





Related posts

Impact of time of onset of symptom of ST-segment elevation myocardial infarction on 1-year rehospitalization for heart failure and mortality.

Newsemia

Transthyretin Amyloid Cardiomyopathy: JACC State-of-the-Art Review

Newsemia

Heart Health and Menopause: 5 Ways to Lower Your Risk of Heart Attack and Stroke

Newsemia

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read More

Privacy & Cookies Policy