An 84-year-old woman with type B Wolff–Parkinson–White (WPW) with Ebstein anomaly was admitted with heart failure. She had rapid wide QRS tachycardia due to accessory pathway (AP) conduction associated with atrial fibrillation (AF). Since transesophageal echocardiography before catheter ablation showed a left atrial thrombus, ablation was performed using a 3D mapping system under AF. After marking the functional tricuspid anulus with intra-cardiac echocardiography, 3D intra-cardiac electrogram visualization (ripple map) during AF enabled clear identification of location of the AP. After ablation, there was no complication of cerebral infarction, and the heart failure improved.

中文翻译：

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Ebstein异常心房颤动期间的辅助通路消融

一位患有 Ebstein 异常的 B 型 Wolff-Parkinson-White (WPW) 的 84 岁女性因心力衰竭入院。由于与心房颤动 (AF) 相关的旁路 (AP) 传导，她出现快速宽 QRS 心动过速。由于导管消融前的经食道超声心动图显示左心房血栓，因此在 AF 下使用 3D 标测系统进行消融。用心内超声心动图标记功能性三尖瓣环后，AF 期间的 3D 心内电图可视化（波纹图）可以清楚地识别 AP 的位置。消融后无脑梗死并发症，心力衰竭好转。