Radiofrequency ablation of an accessory pathway in a surgically created atrioventricular fontan anastomosis: Case report and review of previous published cases

Supraventricular tachyarrhythmias following the Fontan procedure can be lif e-threatening Though most are commonly due to intraatrial reentry, orthodro mic reentrant tachycardia may also be present. Atrioventricular accessory p athways may develop across suture lines following right atrial to right ven tricular anastomosis in patients with tricuspid atresia. We report a case o f a patient who underwent this type of Fontan who developed orthodromic ree ntrant tachycardia and heart failure. An electrophysiological study reveale d the presence of an atrioventricular accessory pathway traversing the Font an anastomosis suture line. Successful radiofrequency ablation of the acces sory pathway led to control of the tachyarrhythmia and improvement of heart failure.