Ablation of atrial tachycardia after surgery for congenital and acquired heart disease using an electroanatomic mapping system: Which circuits to expect in which substrate?

Lukáč, Peter; Pedersen, Anders Kirstein; Mortensen, Peter Thomas; Jensen, Henrik Kjærulf; Hjortdal, Vibeke E.; Hansen, Peter S.

doi:10.1016/j.hrthm.2004.10.034

Cited by 114 publications

(78 citation statements)

References 23 publications

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“…4 Most commonly these IART are CTI-dependent flutters. 21 In our experience, even when no arrhythmia can be induced in the lab, performance of empiric CTI line ablation will often lead to a good outcome. This requires ablation at both sides of the baffle suture line, which can be achieved by either a retrograde approach or a trans-baffle puncture (see Figure 2).…”

Section: Macro Re-entrant Atrial Tachycardias and Atrial Fluttermentioning

confidence: 91%

Ablation of Arrhythmias in Patients with Adult Congenital Heart Disease

Lobo¹,

Griffith²,

Bono³

2011

Arrhythmia &Amp; Electrophysiology Review

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Arrhythmias in adults with congenital heart disease, most commonly related to previous surgical procedures, are a frequent comorbidity in this growing population thanks to the improved outcome of surgical techniques. Re-entrant circuits around areas of scarring and natural barriers, combined with abnormal haemodynamics and the underlying anatomy, are the most common cause for these arrhythmias. They are often poorly tolerated and medical treatment is frequently inadequate. In recent years, catheter ablation has emerged as a successful therapeutic option. New advanced techniques such as the use of modern three-dimensional (3D) navigation systems have contributed to better understanding of the arrhythmia mechanisms and higher success rates of the ablation procedures.In this article we briefly summarise the characteristics of the most common arrhythmias in this patient population and some key aspects in their treatment by catheter ablation.

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Section: Macro Re-entrant Atrial Tachycardias and Atrial Fluttermentioning

confidence: 91%

Ablation of Arrhythmias in Patients with Adult Congenital Heart Disease

Lobo¹,

Griffith²,

Bono³

2011

Arrhythmia &Amp; Electrophysiology Review

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“…23 A patch closing an interatrial septal defect can also become the centre of a MRT circuit (see Figure 7).…”

Section: Figures 1b and 8) And It Is Not Unusual For Two Or More Ecg mentioning

confidence: 99%

Atrial Flutter, Typical and Atypical: A Review

Cosío

2017

Arrhythmia &Amp; Electrophysiology Review

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Clinical electrophysiology has made the traditional classification of rapid atrial rhythms into flutter and tachycardia of little clinical use. Electrophysiological studies have defined multiple mechanisms of tachycardia, both re-entrant and focal, with varying ECG morphologies and rates, authenticated by the results of catheter ablation of the focal triggers or critical isthmuses of re-entry circuits. In patients without a history of heart disease, cardiac surgery or catheter ablation, typical flutter ECG remains predictive of a right atrial re-entry circuit dependent on the inferior vena cava–tricuspid isthmus that can be very effectively treated by ablation, although late incidence of atrial fibrillation remains a problem. Secondary prevention, based on the treatment of associated atrial fibrillation risk factors, is emerging as a therapeutic option. In patients subjected to cardiac surgery or catheter ablation for the treatment of atrial fibrillation or showing atypical ECG patterns, macro-re-entrant and focal tachycardia mechanisms can be very complex and electrophysiological studies are necessary to guide ablation treatment in poorly tolerated cases.

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“…The right atrial isthmus is considered the area between the tricuspid valve annulus and the coronary sinus and the IVC. Targeted ablation of this isthmus region transforms the area of "slow conduction" to an area of "no conduction" and effectively terminates typical AFL (1,61).…”

Section: Aflmentioning

confidence: 99%

“…The right atrial cavotricuspid isthmus represents areas of "slow conduction" which together with an area of unidirectional block contribute to atrial reentry tachycardia (1,61,63). Converting these locations from areas of slow conduction to areas of no conduction using transcatheter radiofrequency ablation techniques can be effective.…”

Section: What We Know About Lesion Sets For Atrial Tachycardiamentioning

confidence: 99%

Prophylactic arrhythmia surgery in association with congenital heart disease

Mavroudis

Deal

2016

Transl. Pediatr.

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Certain congenital heart anomalies make patients more susceptible to arrhythmia development throughout their lives. This poses the question whether prophylactic arrhythmia surgery should be incorporated into reparative open heart procedures for congenital heart disease. There is currently no consensus on what constitutes a standard prophylactic procedure, owing to the questions that remain regarding lesions to be performed; energy sources to use; proximity of energy source or incisions to coronary arteries, sinoatrial node, atrioventricular node; circumstances for right atrial, left atrial, or biatrial appendectomy; and whether to perform a right, left, or biatrial maze procedure. These considerations are important because prophylactic arrhythmia procedures are performed without knowing if the patient will actually develop an arrhythmia in his or her lifetime. By reviewing and summarizing the literature, congenital heart disease patients who are at risk for developing atrial arrhythmias can be identified and lesion sets can be suggested in an effort to standardize experimental protocols for prophylactic arrhythmia surgery.

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Ablation of atrial tachycardia after surgery for congenital and acquired heart disease using an electroanatomic mapping system: Which circuits to expect in which substrate?

Cited by 114 publications

References 23 publications

Ablation of Arrhythmias in Patients with Adult Congenital Heart Disease

Ablation of Arrhythmias in Patients with Adult Congenital Heart Disease

Atrial Flutter, Typical and Atypical: A Review

Prophylactic arrhythmia surgery in association with congenital heart disease

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