Tachyarrhythmias in Congenital Heart Diseases: From Ion Channels to Catheter Ablation

Abstract

Major advances in pediatric cardiology in recent decades, especially surgical techniques, have resulted in an increasing number of patients with congenital heart disease (CHD) surviving to adulthood. This has generated new challenges, particularly with regards to the late onset of complex arrhythmias. Abnormal anatomy, surgical scarring, chronic hypoxemia, hemodynamic compromise, neuro-hormonal abnormalities, and genetic factors can all contribute to creating a unique substrate for arrhythmia development. This review attempts to synthesize the current state of knowledge spanning the spectrum from underlying mechanisms of arrhythmias in patients with congenital heart disease to current ablative strategies. We discuss existing knowledge gaps and highlight important areas for future research.

Postoperative Cardiac Arrhythmias in Pediatric and Neonatal Patients with Congenital Heart Disease—A Narrative Review

“…Isthmus 1 is bordered by the annulus of the tricuspid valve and the area of ventriculotomy, and isthmus 2 is located between the area of ventriculotomy and the annulus of the pulmonary valve. Isthmus 3 is located between the annulus of the pulmonary valve and the closing patch of the ventricular septal defect, and isthmus 4 is located between the tricuspid valve's annulus and the ventricular septal defect [71].…”