Key result
Pre-operative EPS identifies an asymptomatic atriofascicular accessory pathway before Cone repair for Ebstein's anomaly.
Why the study?
Atriofascicular accessory pathways are rare but associated with Ebstein's anomaly, and their detection in young pediatric patients undergoing preoperative evaluation is important as cone repairs are performed at younger ages.
Case Report (n=1)
Highlights the importance of pre-operative electrophysiology studies in young patients with Ebstein's anomaly undergoing Cone repair to identify potentially asymptomatic atriofascicular accessory pathways.
May warrant pre-operative EP study in pediatric Ebstein's cases; hypothesis-generating for routine screening before Cone repair.
We present a case of a 6-year-old with Ebstein's anomaly (EA) who was found to have a right lateral decremental, antegrade only accessory pathway (AP), presumed atriofascicular AP, during a pre-operative electrophysiology study (EPS) prior to da Silva Cone repair (CR). Atriofascicular APs represent <3 % of APs but have an association with EA. To the best of our knowledge, this is the youngest reported case of EA with an atriofascicular AP. Providers should be aware of this possibility, as CRs are being done at younger ages, and they may be discovered in asymptomatic patients.
No takes yet. Share an insight, caveat, or question.
Karolcik et al. (2025) conducted a case report in Ebstein's anomaly (n=1). Pre-operative electrophysiology study (EPS) was evaluated on Discovery of atriofascicular accessory pathway. A pre-operative electrophysiology study in a 6-year-old with Ebstein's anomaly prior to da Silva Cone repair revealed an asymptomatic atriofascicular accessory pathway.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: