Ebstein's anomaly and arrhythmia management

Arrhythmias represent a major issue in patients with Ebstein's anomaly (EA). In these patients, congenital and acquired substrates for arrhythmias coexist and can manifest at different stages of the disease. Atrioventricular reentrant tachycardia related to accessory pathways can occur in children with EA. In adolescents and adults, arrhythmia symptoms are the most common presentation of EA with accessory pathway or nodal atrioventricoular reentrant tachycardia being more common at a younger age, whereas later in life, atrial tachycardia and atrial fibrillation have a higher prevalence. Technical improvements and a better understanding of arrhythmia substrate in these patients have increased transcatheter and surgical ablation success rates, and these strategies should be applied aggressively to treat arrhythmias.