Irrigated-tip catheter ablation of intraatrial reentrant tachycardia in patients late after surgery of congenital heart disease

Noninvasive Characterization of Intra-Atrial Reentrant Tachyarrhythmias After Surgical Repair of Congenital Heart Diseases

“…7 Another study showed that double-loop atrial reentry was present in only 8% of patients with surgical repair for CHD. 27 In the present study, 14 of 31 cases of (45%) IART after surgical repair for CHD were Incision-AT alone, 42% were CTI-AFL, and 13% were double-loop reentry. Moreover, some cases of Incision-AT demonstrated CTI-AFL activation patterns in the inferior and precordial leads of the ECG because of the passive CTI-AFL-like conduction of the septum and/or left atrium or the double-loop reentry.…”

“…[1][2][3][4][5][6][7]27 RF catheter ablation has been used successfully to treat IART 3,4 and the use of electroanatomical mapping (CARTO ® ) has improved our understanding and definition of AT circuits. [5][6][7] However, it has been difficult to noninvasively predict these complex reentrant circuits from the surface ECG.…”

Update on Interventional Electrophysiology in Congenital Heart Disease

“…As a consequence of better equipment and expanded procedural experience, [16][17][18][19][20] the acute success rate for catheter ablation of organized IART or focal atrial tachycardia in CHD has now improved to ≈85% (Table 1). Distinctive patterns for IART circuit location have been uncovered that vary according to underlying CHD lesion and method of repair, allowing one to predict with reasonable certainty the location of usual suspect sites for productive ablation.…”

“…A major advance for ablation in CHD was the introduction of irrigated radiofrequency catheters that have now been demonstrated to improve outcomes significantly. 16,17,19 Another challenge during IART ablation is avoiding damage to the normal conduction tissues. The compact node and His bundle can have unusual locations in many forms of CHD, and the operator must be knowledgeable on these variations to maximize safety.…”

Ablation of Arrhythmias in Patients with Adult Congenital Heart Disease

“…6 Catheter ablation has emerged as a highly successful alternative therapeutic option in most cases, either alone or in combination with ongoing drug treatment. 7,8 New technological advances in catheters and energy sources, threedimensional (3D) navigation mapping systems and the development of magnetic navigation have improved the outcome of ablation procedures to a great extent. 9 In recent years better knowledge of the circuits responsible for these arrhythmias has contributed to the modification of surgical techniques, which may also lead to a reduction in the incidence of cardiac arrhythmias.…”