Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease

Ueda, Akiko; Suman-Horduna, Irina; Mantziari, Lilian; Gujic, Marko; Marchese, Procolo; Ho, Siew Yen; Babu‐Narayan, Sonya V.; Ernst, Sabine

doi:10.1161/circep.113.000415

Cited by 98 publications

(74 citation statements)

References 22 publications

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“…Although an ECG with a typical flutter appearance has good predictive value for CTIdependent flutter in a patient who has not undergone prior catheter ablation of AF, the ECG appearance is less useful in predicting the flutter circuit in a patient who has previously undergone AF ablation. [322][323][324][325] The presence of a positive or biphasic (but dominantly positive) deflection in V1, accompanied by deflections in other leads inconsistent with typical counterclockwise atrial flutter, suggests the presence of an atypical flutter ( Figure 17). Definitive diagnosis requires EP study and intracardiac mapping.…”

Section: Non-isthmus-dependent Atrial Fluttersmentioning

confidence: 99%

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Page¹,

Joglar²,

Caldwell³

et al. 2016

Circulation

337

127

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Section: Non-isthmus-dependent Atrial Fluttersmentioning

confidence: 99%

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Page¹,

Joglar²,

Caldwell³

et al. 2016

Circulation

337

127

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“…The use of a remote magnetic navigation system in the context of a 3D geometric model has been shown to lead to high success rates of catheter ablation of various substrates, including AVNRT in complex CHD. 23 This system was used in 2 patients with D-TGA after an atrial switch procedure in our series. Voltage gradient mapping is a relatively new technique used to visualize the slow pathway.…”

Section: Advanced Mapping and Navigation Systemsmentioning

confidence: 99%

Atrioventricular Nodal Reentrant Tachycardia in Patients With Congenital Heart Disease

Papagiannis¹,

Beissel²,

Krause³

et al. 2017

Circ: Arrhythmia and Electrophysiology

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Background-The relationship of atrioventricular nodal reentrant tachycardia to congenital heart disease (CHD) and the outcome of catheter ablation in this population have not been studied adequately. Methods and Results-A multicenter retrospective study was performed on patients with CHD who had atrioventricular nodal reentrant tachycardia and were treated with catheter ablation. There were 109 patients (61 women), aged 22.1±13.4 years. The majority, 86 of 109 (79%), had CHD resulting in right heart pressure or volume overload. Patients were divided into 2 groups: group A (n=51) with complex CHD and group B (n=58) with simple CHD. There were no significant differences between groups in patients' growth parameters, use of 3-dimensional imaging, and type of ablation (radiofrequency versus cryoablation

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“…In case of a retrograde approach through the aorta, lead manoeuvring in the atrium is very difficult and some areas may be impossible to reach. Remote magnetic navigation systems are a significant improvement in such a situation, as they allow reaching nearly all atrial areas, which translates to better ablation outcomes [19]. Unfortunately, such systems are currently unavailable in Poland.…”

Section: Discussionmentioning

confidence: 99%

Atrial tachycardia ablation in patients with a functional single ventricle after the Fontan surgery

et al. 2016

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A b s t r a c tBackground: Atrial tachyarrhythmias are a leading source of morbidity and mortality after Fontan-type procedures and antiarrhythmic drug therapy is often ineffective in these patients. Aim:To evaluate short-and long-term outcomes of radiofrequency current ablation for atrial tachycardia (AT) in patients after the Fontan procedure, and to report clinical, electrophysiological and electroanatomical characteristics of these arrhythmias. Methods:We retrospectively analysed data obtained in 8 patients (5 males, 3 females) after the Fontan procedure who underwent ablation for AT between 2002 and 2013. In order to compare the clinical impact of arrhythmia before and after ablation, we used the modified arrhythmia score, ranging from 0 (no arrhythmia activity) to 12 (very severe arrhythmia). In all patients, electroanatomical mapping using the CARTO system was performed, allowing semiquantification of low-voltage (< 0.5 mV) areas and scars.Results: Seven patients had an atriopulmonary connection and 1 patient had an extracardiac conduit. The mean patient age was 9.4 ± 3.1 years at the time of the Fontan procedure and 26.2 ± 4.6 years at the time of the first ablation. A total of 18 ablations were performed with no complications, 1 to 4 (median 2.5) procedures per patient. In patients who had more than 1 ablation, the mean time from the first to the last procedure was 34.8 months (range 1-64 months). In individual patients, 1 to 4 (median 2.5) different ATs were observed, with the mean tachycardia cycle length of 334 ± 95 ms. In 6 patients, low-voltage area (< 0.5 mV) comprised 25-50% of the right atrium, and in two others it comprised 10-25% and < 10% of the right atrium, respectively. Seven procedures were fully successful (ablation of all ATs), 7 were partially successful (ablation of only some AT, including clinical arrhythmia, but not of all ATs) and 4 were unsuccessful (failed ablation of clinical AT). The mean procedural, fluoroscopy and ablation times were 176 ± 54.6, 13.7 ± 5.7 and 21.7 ± 11.9 min, respectively. Freedom from arrhythmia during the mean follow-up of 58.6 ± 46 months (range 11-127 months) since the last procedure was obtained in 4 patients. The median arrhythmia score after the last ablation was significantly reduced compared to baseline (4.5 vs. 8; p < 0.05).Conclusions: Catheter ablation of AT in patients after the Fontan procedure is safe but its acute and long-term efficacy is limited. Due to complex and extensive substrate, along with complex anatomy, recurrences are frequent and patients may require repeat ablation procedures. Suppression of arrhythmia is associated with an improved clinical status of the patients.

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Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease

Cited by 98 publications

References 22 publications

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia

Atrioventricular Nodal Reentrant Tachycardia in Patients With Congenital Heart Disease

Atrial tachycardia ablation in patients with a functional single ventricle after the Fontan surgery

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