Radiofrequency catheter ablation for drug-refractory paroxysmal atrial fibrillation in a patient with Ebstein’s anomaly

Ebstein’s anomaly is a rare congenital heart disease in which the tricuspid valve is displaced toward the apex of the right ventricle (RV). It is commonly associated with atrial arrhythmia, especially Wolff-Parkinson-White syndrome. In fact, up to 20% of patients with Ebstein’s anomaly have 1 or more accessory pathways owing to tricuspid valve malformation, most of which are located along these tricuspid valves. In addition, atrial fibrillation (AF) can develop with aging. Although the success rate of catheter ablation of an accessory pathway is lower in patients with Ebstein’s anomaly than in the general population, catheter ablation is the most favorable treatment strategy. In patients with AF, however, concomitant surgical ablation at the time of corrective surgery is preferred. To the best of our knowledge, there has been no report of catheter ablation without corrective surgery for AF in a patient with Ebstein’s anomaly. Here, we present the case of an adult patient with Ebstein’s anomaly who developed drug-refractory and intolerant paroxysmal AF, but did not yet require corrective surgery.