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Paul T, Krause U, Sanatani S, Etheridge SP. Advancing the science of management of arrhythmic disease in children and adult congenital heart disease patients within the last 25 years. Europace 2023; 25:euad155. [PMID: 37622573 PMCID: PMC10450816 DOI: 10.1093/europace/euad155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 05/30/2023] [Indexed: 08/26/2023] Open
Abstract
This review article reflects how publications in EP Europace have contributed to advancing the science of management of arrhythmic disease in children and adult patients with congenital heart disease within the last 25 years. A special focus is directed to congenital atrioventricular (AV) block, the use of pacemakers, cardiac resynchronization therapy devices, and implantable cardioverter defibrillators in the young with and without congenital heart disease, Wolff-Parkinson-White syndrome, mapping and ablation technology, and understanding of cardiac genomics to untangle arrhythmic sudden death in the young.
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Affiliation(s)
- Thomas Paul
- Department of Pediatric Cardiology, Intensive Care Medicine and Neonatology, Pediatric Heart Center, Georg-August-University Medical Center, Robert-Koch-Str, 40, Göttingen D-37075, Germany
| | - Ulrich Krause
- Department of Pediatric Cardiology, Intensive Care Medicine and Neonatology, Pediatric Heart Center, Georg-August-University Medical Center, Robert-Koch-Str, 40, Göttingen D-37075, Germany
| | - Shubhayan Sanatani
- Children’s Heart Centre, British Columbia Children’s Hospital, Vancouver, BC, Canada
| | - Susan P Etheridge
- Pediatric Cardiology, University of Utah School of Medicine and Primary Children’s Medical Center, Salt Lake City, UT
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2
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Drago F, Tamborrino PP. Atrial Flutter in Pediatric Patients. Card Electrophysiol Clin 2022; 14:495-500. [PMID: 36153129 DOI: 10.1016/j.ccep.2022.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Atrial flutter (AFL) in pediatric patients is a rare condition as the physical dimensions of the immature heart are inadequate to support the arrhythmia. This low incidence makes it difficult for patients in this particular setting to be studied. AFL accounts for 30% of fetal tachyarrhythmias, 11% to 18% of neonatal tachyarrhythmias, and 8% of supraventricular tachyarrhythmias in children older than 1 year of age. Transesophageal overdrive pacing can be used, instead, with lower success rate (60%-70%). The recommended drugs are digoxin which can decrease the ventricular rate until the spontaneous interruption of the AFL. Digoxin can be combined with flecainide or amiodarone in case of failure.
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Affiliation(s)
- Fabrizio Drago
- Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Piazza S. Onofrio 4, Rome 00165, Italy.
| | - Pietro Paolo Tamborrino
- Paediatric Cardiology and Cardiac Arrhythmias Complex Unit, Department of Paediatric Cardiology and Cardiac Surgery, Bambino Gesù Children's Hospital and Research Institute, Piazza S. Onofrio 4, Rome 00165, Italy
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Külahçıoğlu Ş, Kültürsay B, Çelik M, Demir S, Adademir T, Uslu A. Surgical treatment of a difficult case of atrial tachycardia requiring multiple electrophysiologic procedures. J Electrocardiol 2022; 74:1-4. [PMID: 35868127 DOI: 10.1016/j.jelectrocard.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 06/26/2022] [Accepted: 07/11/2022] [Indexed: 12/13/2022]
Abstract
A 34-year-old male with incessant drug-refractory atrial tachycardia (AT) was referred to our clinic for catheter ablation. The procedure began with endocardial activation mapping. The earliest endocardial activation site was in the right atrial appendage (RAA). The procedure continued with mapping of the left atrium through a transseptal approach. The earliest local activation was recorded at the anterior site of the right pulmonary veins. Radiofrequency (RF) ablation of both localizations was performed synchronously but failed to terminate the arrhythmia. The procedure continued with isolation of the RAA using cryoballoon but failed again due to the anomalous structure of the RAA. Then, epicardial RF ablation was attempted but failed. Finally, AT could only be terminated by surgical excision of the RAA.
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Affiliation(s)
- Şeyhmus Külahçıoğlu
- Department of Cardiology, Kartal Koşuyolu Education and Research Hospital, İstanbul, Turkey.
| | - Barkın Kültürsay
- Department of Cardiology, Kartal Koşuyolu Education and Research Hospital, İstanbul, Turkey
| | - Mehmet Çelik
- Department of Cardiology, Kartal Koşuyolu Education and Research Hospital, İstanbul, Turkey
| | - Serdar Demir
- Department of Cardiology, Kartal Koşuyolu Education and Research Hospital, İstanbul, Turkey
| | - Taylan Adademir
- Department of Cardiovascular Surgery, Kartal Koşuyolu Education and Research Hospital, İstanbul, Turkey
| | - Abdülkadir Uslu
- Department of Cardiology, Kartal Koşuyolu Education and Research Hospital, İstanbul, Turkey
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Chong L, Gopinathannair R, Ahmad A, Mar P, Olshansky B. Arrhythmia-Induced Cardiomyopathy: Mechanisms and Risk Assessment to Guide Management and Follow-Up. CURRENT CARDIOVASCULAR RISK REPORTS 2022. [DOI: 10.1007/s12170-022-00699-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Benak A, Kupo P, Bencsik G, Makai A, Saghy L, Pap R. Is prophylactic ablation of the cavotricuspid and peri-incisional isthmus justified in patients with postoperative atrial flutter after right atriotomy? J Cardiovasc Electrophysiol 2022; 33:1190-1196. [PMID: 35362181 DOI: 10.1111/jce.15481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 02/03/2022] [Accepted: 02/20/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND The two most common postoperative atrial flutter (AFL) circuits after right atriotomy are the cavotricuspid isthmus (CTI) dependent and the lateral, peri-incisional. We investigated whether radiofrequency ablation (RFA) of both circuits results in more favorable long-term outcomes. METHODS Single-center retrospective cohort study of consecutive patients who underwent RFA of AFL after open-heart surgery. The effect of surgery type and RFA strategy on AFL recurrence was evaluated. RESULTS One hundred and forty-two patients (mean age 64.5 ± 12.7 years, 65.% male) were enrolled. Patients with right atrial (RA) flutter (n=124) were divided into two groups based on the index RFA procedure: only one RA circuit was ablated (Group 1, n= 84, 67.7%) or both the CTI and the peri-incisional circuit ablated (Group 2, n= 40, 32.3%). The previous open-heart surgery was categorized based on the extension of the RA incision: limited (Type A) or extended (Type B) atriotomy. After a mean follow-up of 36±28 months, flutter recurrence was not different among patients with limited RA atriotomy (25% vs. 22% in Group 1A and 2A, respectively, p=1.0). However, after type B surgery, ablation of both AFL circuits was associated with a reduced recurrence rate (63% vs. 26% in Group 1B and 2B, respectively, p=0.002). CONCLUSIONS In patients with postoperative RA flutter after extended right atriotomy, ablation of both the CTI and the peri-incisional isthmus significantly reduces the AFL recurrence rate. Prophylactic ablation of both isthmi, even if not proven to support reentry, is reasonable in this population. Keywords This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Attila Benak
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Szeged, Hungary
| | - Peter Kupo
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Szeged, Hungary
| | - Gabor Bencsik
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Szeged, Hungary
| | - Attila Makai
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Szeged, Hungary
| | - Laszlo Saghy
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Szeged, Hungary
| | - Robert Pap
- 2nd Department of Internal Medicine and Cardiology Centre, University of Szeged, Szeged, Hungary
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Brouwer C, Hebe J, Lukac P, Nürnberg JH, Cosedis Nielsen J, de Riva Silva M, Blom N, Hazekamp M, Zeppenfeld K. Contemporary Patients With Congenital Heart Disease: Uniform Atrial Tachycardia Substrates Allow for Clear Ablation Endpoints With Improved Long-Term Outcome. Circ Arrhythm Electrophysiol 2021; 14:e009695. [PMID: 34465129 DOI: 10.1161/circep.120.009695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Charlotte Brouwer
- Department of Cardiology (C.B., M.d.R., K.Z.), Leiden University Medical Center, the Netherlands
| | - Joachim Hebe
- Center for Electrophysiology, Bremen, Germany (J.H., J.-H.N.)
| | - Peter Lukac
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (P.L., J.C.N.)
| | | | - Jens Cosedis Nielsen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (P.L., J.C.N.)
| | - Marta de Riva Silva
- Department of Cardiology (C.B., M.d.R., K.Z.), Leiden University Medical Center, the Netherlands
| | - Nico Blom
- Department of Pediatric Cardiology (N.B.), Leiden University Medical Center, the Netherlands
| | - Mark Hazekamp
- Department of Cardiothoracic Surgery, Leiden University Medical Center, the Netherlands (M.H)
| | - Katja Zeppenfeld
- Department of Cardiology (C.B., M.d.R., K.Z.), Leiden University Medical Center, the Netherlands
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Early outcomes of usage of cryoFORM® probe for cryomaze procedure in congenital heart surgery. Cardiol Young 2020; 30:1874-1879. [PMID: 32988422 DOI: 10.1017/s1047951120003029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This study aimed to evaluate the early outcomes of patients who underwent a concomitant therapeutic maze procedure for congenital heart surgery. MATERIALS AND METHODS Between 2019 and 2020, eight patients underwent surgical cryoablation by using the same type of cryoablation probe. RESULTS Three patients had atrial flutter, two had Wolf-Parkinson-White syndrome, two intra-atrial reentrant tachycardia, and one had atrial fibrillation. Four patients underwent electrophysiological study. Preoperatively, one patient was on 3, two were on 2, five were on 1 antiarrhythmic drug. Six patients underwent right atrial maze and two underwent bilateral atrial maze. Five out of six right atrial maze patients underwent right atrial reduction. Nine different lesion sets were used. Some of the lesions were combined and applied as one lesion. In Ebstein's anomaly patients, the lesion from coronary sinus to displaced tricuspid annulus was delicately performed. The single ventricle patient with heterotaxy had junctional rhythm at the time of discharge and was the only patient who experienced atrial extrasystoles 2 months after discharge. Seven of the eight patients were on sinus rhythm. No patient needed permanent pacemaker placement. CONCLUSION Cryomaze procedure can be applied in congenital heart diseases with acceptable arrhythmia-free rates by selecting the appropriate materials and suitable lesion sets. The application of cryomaze in heterotaxy patients can be challenging due to differences in the conduction system and complex anatomy. Consensus with the electrophysiology team about the choice of the right-left or biatrial maze procedure is mandatory for operational success.
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Nagai T, Kawakami H, Sasaki Y, Fujii A, Inoue K, Ikeda S, Yamaguchi O. Atrial tachycardia with multiple reconductions across the surgical incision. J Cardiovasc Electrophysiol 2020; 31:2526-2529. [PMID: 32713018 DOI: 10.1111/jce.14690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/16/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Abstract
Incisional atrial tachycardia (AT) with multiple penetrating points on one surgical incision has not been reported yet. We present a case of incisional AT following mitral valve annuloplasty with a superior transseptal approach, in which two reconduction sites were parts of the reentrant circuit. Radiofrequency ablation at the reconduction site successfully terminated the tachycardia. A total of four penetrating points were found on the incision line, and radiofrequency ablation at these sites was completed. Detailed mapping of possible reconduction sites along the incision line should be performed to avoid further instances of AT following open heart surgery.
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Affiliation(s)
- Takayuki Nagai
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Hiroshi Kawakami
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Yasuhiro Sasaki
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Akira Fujii
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Katsuji Inoue
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Shuntaro Ikeda
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Osamu Yamaguchi
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
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Mantziari L, Butcher C, Shi R, Kontogeorgis A, Opel A, Chen Z, Haldar S, Panikker S, Hussain W, Jones DG, Gatzoulis MA, Markides V, Ernst S, Wong T. Characterization of the Mechanism and Substrate of Atrial Tachycardia Using Ultra-High-Density Mapping in Adults With Congenital Heart Disease: Impact on Clinical Outcomes. J Am Heart Assoc 2020; 8:e010535. [PMID: 30773973 PMCID: PMC6405650 DOI: 10.1161/jaha.118.010535] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Atrial tachycardia (AT) is common in patients with adult congenital heart disease and is challenging to map and ablate. We used ultra‐high‐density mapping to characterize the AT mechanism and investigate whether substrate characteristics are related to ablation outcomes. Methods and Results A total of 50 ATs were mapped with ultra‐high‐density mapping in 23 procedures. Patients were followed up for up to 12 months. Procedures were classified to group A if there was 1 single AT induced (n=12) and group B if there were ≥2 ATs induced (n=11 procedures). AT mechanism per procedure was macro re‐entry (n=10) and localized re‐entry (n=2) in group A and multiple focal (n=6) or multiple macro re‐entry (n=5) in group B. Procedure duration, low voltage area (0.05–0.5 mV), and low voltage area indexed for volume were higher in group B (159 [147–180] versus 412 [352–420] minutes, P<0.001, 22.6 [12.2–29.8] versus 54.2 [51.1–61.6] cm2, P=0.014 and 0.17 [0.12–0.21] versus 0.26 [0.23–0.27] cm2/mL, P=0.024 accordingly). Dense scar (<0.05 mV) and atrial volume were similar between groups. Acute success and freedom from arrhythmia recurrence were worse in group B (100% versus 77% P=0.009 and 11.3, CI 9.8–12.7 versus 4.9, CI 2.2–7.6 months, log rank P=0.004). Indexed low voltage area ≥0.24 cm2/mL could predict recurrence with 100% sensitivity and 77% specificity (area under the curve 0.923, P=0.007). Conclusions Larger low voltage area but not dense scar is associated with the induction of multiple focal or re‐entry ATs, which are subsequently associated with longer procedure duration and worse acute and midterm clinical outcomes.
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Affiliation(s)
- Lilian Mantziari
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Charles Butcher
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Rui Shi
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | | | - Aaisha Opel
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Zhong Chen
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Shouvik Haldar
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Sandeep Panikker
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Wajid Hussain
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - David Gareth Jones
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | | | - Vias Markides
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Sabine Ernst
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
| | - Tom Wong
- 1 Royal Brompton and Harefield NHS Foundation Trust London United Kingdom
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Alken FA, Klatt N, Muenkler P, Scherschel K, Jungen C, Akbulak RO, Kahle AK, Gunawardene M, Jularic M, Dinshaw L, Hartmann J, Eickholt C, Willems S, Stute F, Mueller G, Blankenberg S, Rickers C, Sinning C, Zengin-Sahm E, Meyer C. Advanced mapping strategies for ablation therapy in adults with congenital heart disease. Cardiovasc Diagn Ther 2019; 9:S247-S263. [PMID: 31737533 DOI: 10.21037/cdt.2019.10.02] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Ultra-high density mapping (HDM) is a promising tool in the treatment of patients with complex arrhythmias. In adults with congenital heart disease (CHD), rhythm disorders are among the most common complications but catheter ablation can be challenging due to heterogenous anatomy and complex arrhythmogenic substrates. Here, we describe our initial experience using HDM in conjunction with novel automated annotation algorithms in patients with moderate to great CHD complexity. Methods We studied a series of consecutive adult patients with moderate to great CHD complexity and an indication for catheter ablation due to symptomatic arrhythmia. HDM was conducted using the Rhythmia™ mapping system and a 64-electrode mini-basket catheter for identification of anatomy, voltage, activation pattern and critical areas of arrhythmia for ablation guidance. To investigate novel advanced mapping strategies, postprocedural signal processing using the Lumipoint™ software was applied. Results In 19 patients (53±3 years; 53% male), 21 consecutive ablation procedures were conducted. Procedures included ablation of atrial fibrillation (n=7; 33%), atrial tachycardia (n=11; 52%), atrioventricular accessory pathway (n=1; 5%), the atrioventricular node (n=1; 5%) and ventricular arrhythmias (n=4; 19%). A total of 23 supraventricular and 8 ventricular arrhythmias were studied with the generation of 56 complete high density maps (atrial n=43; ventricular n=11, coronary sinus n=2) and an average of 12,043±1,679 mapping points. Multiple arrhythmias were observed in n=7 procedures (33% of procedures; range of arrhythmias detected 2-4). A total range of 1-4 critical areas were defined per procedure and treated within a radiofrequency application time of 16 (interquartile range 12-45) minutes. Postprocedural signal processing using Lumipoint™ allowed rapid annotation of fractionated signals within specific windows of interest. This supported identification of a practical critical isthmus in 20 out of 27 completed atrial and ventricular tachycardia activation maps. Conclusions Our findings suggest that HDM in conjunction with novel automated annotation algorithms provides detailed insights into arrhythmia mechanisms and might facilitate tailored catheter ablation in patients with moderate to great CHD complexity.
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Affiliation(s)
- Fares-Alexander Alken
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Niklas Klatt
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Paula Muenkler
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Katharina Scherschel
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Christiane Jungen
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Ruken Oezge Akbulak
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Ann-Kathrin Kahle
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Melanie Gunawardene
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Mario Jularic
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Leon Dinshaw
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Jens Hartmann
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Christian Eickholt
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Stephan Willems
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Fridrike Stute
- Department of Pediatric Cardiology/Pediatric Cardiac Surgery, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Goetz Mueller
- Department of Pediatric Cardiology/Pediatric Cardiac Surgery, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Stefan Blankenberg
- DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.,Department of General and Interventional Cardiology, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Carsten Rickers
- Department of Pediatric Cardiology/Pediatric Cardiac Surgery, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,Adults with Congenital Heart Disease Section, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Christoph Sinning
- Department of General and Interventional Cardiology, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Elvin Zengin-Sahm
- Department of General and Interventional Cardiology, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - Christian Meyer
- Department of Cardiology-Electrophysiology, cNEP, Cardiac Neuro- and Electrophysiology Research Group, University Heart Center, University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.,DZHK (German Center for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
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11
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Giamberti A, Pluchinotta FR, Chessa M, Varrica A, Vitale R, Frigiola A, Pappone C, Ranucci M. Surgery for supraventricular tachycardia and congenital heart defects: long-term efficacy of the combined approach in adult patients. Europace 2018; 19:1542-1548. [PMID: 27738072 DOI: 10.1093/europace/euw278] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/09/2016] [Indexed: 11/14/2022] Open
Abstract
Aims Supraventricular arrhythmias are a major cause of morbidity and mortality in adult patients with congenital heart disease (CHD). Intraoperative ablation offers an alternative for patients who failed ablation procedures or are requiring concomitant surgical intervention. We present our long-term results with the surgical treatment of arrhythmias in adults with CHD (ACHD) undergoing elective cardiac surgery and the clinical predictors for arrhythmia recurrence. Methods and results Between 2002 and 2013, 80 consecutive patients with CHD, mean age of 39 years, underwent intraoperative ablation with monopolar irrigated radiofrequency during cardiac surgery procedures. Significant clinical predictors of arrhythmia recurrence were determined by univariate analysis. We performed 47 right-sided Maze procedures, and 33 Cox-Maze III procedures. In 75 survivors, the ablation was effective immediately. Over an average follow-up period of 72 months (12-155 months), arrhythmias recurred in nine (20%) patients after right-sided Maze, and in six (19%) patients after Cox-Maze III. Eleven patients were controlled with medical therapy, three underwent catheter ablation of the arrhythmia, and one required a permanent pacemaker. Preoperative arrhythmia length ≥3 years (P ≤ 0.001), tetralogy of Fallot (P ≤ 0.006), and preoperative atrial fibrillation (P ≤ 0.016) were associated with recurrence arrhythmia. Conversely, NYHA class <3 (P ≤ 0.047) was associated with a lower risk of recurrence. Conclusion Surgical treatment of unresponsive supraventricular arrhythmia during concomitant cardiac surgery in ACHD is a safe and effective procedure. Freedom from arrhythmias recurrence is 75% after 6 years of follow-up. Long-term recurrence of arrhythmia in these patients seems to be strongly correlated to preoperative arrhythmia duration.
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Affiliation(s)
- Alessandro Giamberti
- Department of Congenital Cardiac Surgery and GUCH Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se MI, Italy
| | - Francesca R Pluchinotta
- Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato M.se MI, Italy
| | - Massimo Chessa
- Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato M.se MI, Italy
| | - Alessandro Varrica
- Department of Congenital Cardiac Surgery and GUCH Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se MI, Italy
| | - Raffaele Vitale
- Department of Electrophysiology, IRCCS Policlinico San Donato, San Donato M.se MI, Italy
| | - Alessandro Frigiola
- Department of Congenital Cardiac Surgery and GUCH Unit, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato M.se MI, Italy
| | - Carlo Pappone
- Department of Electrophysiology, IRCCS Policlinico San Donato, San Donato M.se MI, Italy
| | - Marco Ranucci
- Department of Cardiothoracic and Vascular Anesthesia and ICU, IRCCS Policlinico San Donato, San Donato M.se MI, Italy
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12
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Roca-Luque I, Rivas-Gándara N, Dos Subirà L, Francisco Pascual J, Pijuan-Domenech A, Pérez-Rodon J, Subirana-Domenech M, Santos-Ortega A, Rosés-Noguer F, Miranda-Barrio B, Ferreira-Gonzalez I, Casaldàliga Ferrer J, García-Dorado García D, Moya Mitjans A. Long-Term Follow-Up After Ablation of Intra-Atrial Re-Entrant Tachycardia in Patients With Congenital Heart Disease. JACC Clin Electrophysiol 2018; 4:771-780. [PMID: 29929671 DOI: 10.1016/j.jacep.2018.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/02/2018] [Accepted: 04/26/2018] [Indexed: 12/15/2022]
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13
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Hernández-Madrid A, Paul T, Abrams D, Aziz PF, Blom NA, Chen J, Chessa M, Combes N, Dagres N, Diller G, Ernst S, Giamberti A, Hebe J, Janousek J, Kriebel T, Moltedo J, Moreno J, Peinado R, Pison L, Rosenthal E, Skinner JR, Zeppenfeld K, Sticherling C, Kautzner J, Wissner E, Sommer P, Gupta D, Szili-Torok T, Tateno S, Alfaro A, Budts W, Gallego P, Schwerzmann M, Milanesi O, Sarquella-Brugada G, Kornyei L, Sreeram N, Drago F, Dubin A. Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Europace 2018; 20:1719-1753. [DOI: 10.1093/europace/eux380] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Antonio Hernández-Madrid
- Department of Cardiology, Arrhythmia Unit, Ramón y Cajal Hospital, Alcalá University, Carretera Colmenar Viejo, km 9, 100, Madrid, Spain
| | - Thomas Paul
- Department of Pediatric Cardiology and Intensive Care Medicine, Georg August University Medical Center, Robert-Koch-Str. 40, Göttingen, Germany
| | - Dominic Abrams
- PACES (Pediatric and Congenital Electrophysiology Society) Representative, Department of Cardiology, Boston Childreńs Hospital, Boston, MA, USA
| | - Peter F Aziz
- HRS Representative, Pediatric Electrophysiology, Cleveland Clinic Children's, Cleveland, OH, USA
| | - Nico A Blom
- Department of Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Academical Medical Center, Amsterdam, The Netherlands
| | - Jian Chen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Massimo Chessa
- Pediatric and Adult Congenital Heart Centre-University Hospital, IRCCS Policlinico San Donato, Milan, Italy
| | - Nicolas Combes
- Arrhythmia Unit, Department of Pediatric and Adult Congenital Heart Disease, Clinique Pasteur, Toulouse, France
| | - Nikolaos Dagres
- Department of Electrophysiology, University Leipzig Heart Center, Leipzig, Germany
| | | | - Sabine Ernst
- Royal Brompton and Harefield Hospital, London, UK
| | - Alessandro Giamberti
- Congenital Cardiac Surgery Unit, Policlinico San Donato, University and Research Hospital, Milan, Italy
| | - Joachim Hebe
- Center for Electrophysiology at Heart Center Bremen, Bremen, Germany
| | - Jan Janousek
- 2nd Faculty of Medicine, Children's Heart Centre, Charles University in Prague and Motol University Hospital, Prague, Czech Republic
| | - Thomas Kriebel
- Westpfalz-Klinikum Kaiserslautern, Children’s Hospital, Kaiserslautern, Germany
| | - Jose Moltedo
- SOLAECE Representative, Head Pediatric Electrophysiology, Section of Pediatric Cardiology Clinica y Maternidad Suizo Argentina, Buenos Aires, Argentina
| | - Javier Moreno
- Department of Cardiology, Arrhythmia Unit, Ramón y Cajal Hospital, Alcalá University, Carretera Colmenar Viejo, km 9, 100, Madrid, Spain
| | - Rafael Peinado
- Department of Cardiology, Arrhythmia Unit, Hospital la Paz, Madrid, Spain
| | - Laurent Pison
- Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Eric Rosenthal
- Consultant Paediatric and Adult Congenital Cardiologist, Evelina London Children's Hospital, Guy's and St Thomas' Hospital Trust, London, UK
| | - Jonathan R Skinner
- APHRS Representative, Paediatric and Congenital Cardiac Services Starship Childreńs Hospital, Grafton, Auckland, New Zealand
| | - Katja Zeppenfeld
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Joseph Kautzner
- Institute For Clinical and Experimental Medicine, Prague, Czech Republic
| | - Erik Wissner
- University of Illinois at Chicago, 840 S. Wood St., 905 S (MC715), Chicago, IL, USA
| | - Philipp Sommer
- Heart Center Leipzig, Struempellstr. 39, Leipzig, Germany
| | - Dhiraj Gupta
- Consultant Electrophysiologist Liverpool Heart and Chest Hospital, Honorary Senior Lecturer Imperial College London and University of Liverpool, Liverpool, UK
| | | | - Shigeru Tateno
- Chiba Cerebral and Cardiovascular Center, Tsurumai, Ichihara, Chiba, Japan
| | | | - Werner Budts
- UZ Leuven, Campus Gasthuisberg, Herestraat 49, Leuven, Belgium
| | | | - Markus Schwerzmann
- INSELSPITAL, Universitätsspital Bern, Universitätsklinik für Kardiologie, Zentrum für angeborene Herzfehler ZAH, Bern, Switzerland
| | - Ornella Milanesi
- Department of Woman and Child's Health, University of Padua, Padua Italy
| | - Georgia Sarquella-Brugada
- Pediatric Arrhythmias, Electrophysiology and Sudden Death Unit, Department of Cardiology, Hospital Sant Joan de Déu, Barcelona - Universitat de Barcelona, Passeig Sant Joan de Déu, 2, Esplugues, Barcelona, Catalunya, Spain
| | - Laszlo Kornyei
- Gottsegen Gyorgy Orszagos Kardiologiai, Pediatric, Haller U. 29, Budapest, Hungary
| | - Narayanswami Sreeram
- Department of Pediatric Cardiology, University Hospital Of Cologne, Kerpenerstrasse 62, Cologne, Germany
| | - Fabrizio Drago
- IRCCS Ospedale Pediatrico Bambino Gesù, Piazza Sant'Onofrio 4, Roma
| | - Anne Dubin
- Division of Pediatric Cardiology, 750 Welch Rd, Suite 321, Palo Alto, CA, USA
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14
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Moak JP. Ablation of Atrial Arrhythmias in Postoperative Congenital Heart Disease Patients: Have We Reached the Upper Limit of Success or Is It Time for a Paradigm Shift in Strategy? Circ Arrhythm Electrophysiol 2017; 10:CIRCEP.117.006021. [PMID: 29247035 DOI: 10.1161/circep.117.006021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jeffrey P Moak
- From the Division of Cardiology, Children's National Health System, Washington, DC.
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Abstract
Patients with repaired or unrepaired congenital heart anomalies are at increased risk for arrhythmia development throughout their lives, often paralleling the need for reoperations for hemodynamic residua. The ability to incorporate arrhythmia surgery into reoperations can result in improvement in functional class and decreased need for antiarrhythmic medications. Every reoperation for congenital heart disease can be viewed as an opportunity to assess the electrical and arrhythmia substrates and to intervene to improve the arrhythmias and the hemodynamic condition of the patient. The authors review and summarize the operative techniques for arrhythmia surgery that are based on the arrhythmia mechanisms.
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Affiliation(s)
- Barbara J Deal
- Feinberg School of Medicine, Northwestern University, 303 East Chicago Avenue, Chicago, IL 60611, USA.
| | - Constantine Mavroudis
- Johns Hopkins Children's Heart Surgery, Florida Hospital for Children, 2501 N Orange Avenue, Suite 540, Orlando, FL 32804, USA
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16
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Combes N, Derval N, Hascoët S, Zhao A, Amet D, Le Bloa M, Maltret A, Heitz F, Thambo JB, Marijon E. Ablation of supraventricular arrhythmias in adult congenital heart disease: A contemporary review. Arch Cardiovasc Dis 2017; 110:334-345. [DOI: 10.1016/j.acvd.2017.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 10/19/2022]
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Sanatani S, Cunningham T, Khairy P, Cohen MI, Hamilton RM, Ackerman MJ. The Current State and Future Potential of Pediatric and Congenital Electrophysiology. JACC Clin Electrophysiol 2017; 3:195-206. [PMID: 29759513 DOI: 10.1016/j.jacep.2017.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/11/2017] [Accepted: 01/16/2017] [Indexed: 10/19/2022]
Abstract
Pediatric electrophysiologists specialize in the diagnosis and treatment of rhythm abnormalities in pediatric, congenital heart disease, and inherited arrhythmia syndrome patients. The field originated out of the unique knowledge base that rhythm management in young patients required. In the 1970s, pediatric electrophysiology was recognized as a distinct cardiac subspecialty and it has evolved rapidly since that time. Despite the considerable growth in personnel, technology, and complexity that the field has undergone, further opportunities to progress pediatric electrophysiology exist. In this review, we highlight some of the clinical focus of pediatric and adult congenital electrophysiologists to date and identify areas within this specialty where the pediatric and congenital electrophysiology community could come together in order to drive improvements in rhythm management for patients.
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Affiliation(s)
- Shubhayan Sanatani
- Children's Heart Centre, British Columbia Children's Hospital, Vancouver, British Columbia, Canada.
| | - Taylor Cunningham
- Children's Heart Centre, British Columbia Children's Hospital, Vancouver, British Columbia, Canada
| | - Paul Khairy
- Adult Congenital Heart Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Mitchell I Cohen
- Phoenix Children's Heart Center, Phoenix Children's Hospital, Phoenix, Arizona
| | - Robert M Hamilton
- Division of Cardiology, The Labatt Heart Centre, The Hospital for Sick Children, and Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Michael J Ackerman
- Departments of Cardiovascular Diseases, Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics, Divisions of Heart Rhythm Services and Pediatric Cardiology, Windland Smith Rice Sudden Death Genomics Laboratory, Rochester, Minnesota
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18
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LOOMBA ROHITS, BUELOW MATTHEWW, AGGARWAL SAURABH, ARORA ROHITR, KOVACH JOSHUA, GINDE SALIL. Arrhythmias in Adults with Congenital Heart Disease: What Are Risk Factors for Specific Arrhythmias? PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2017; 40:353-361. [DOI: 10.1111/pace.12983] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 08/24/2016] [Accepted: 10/07/2016] [Indexed: 10/20/2022]
Affiliation(s)
- ROHIT S. LOOMBA
- Children's Hospital of Wisconsin/Medical College of Wisconsin; Milwaukee Wisconsin
| | - MATTHEW W. BUELOW
- Children's Hospital of Wisconsin/Medical College of Wisconsin; Milwaukee Wisconsin
| | | | | | - JOSHUA KOVACH
- Children's Hospital of Wisconsin/Medical College of Wisconsin; Milwaukee Wisconsin
| | - SALIL GINDE
- Children's Hospital of Wisconsin/Medical College of Wisconsin; Milwaukee Wisconsin
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19
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Acena M, Anguera I, Dallaglio PD, Rodriguez M, Sabaté X. Atrial Fibrillation Ablation in Adults With Repaired Congenital Heart Disease. J Atr Fibrillation 2016; 8:1363. [PMID: 27909479 DOI: 10.4022/jafib.1363] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 02/08/2016] [Accepted: 02/14/2016] [Indexed: 11/10/2022]
Abstract
The incidence of atrial fibrillation (AF) in congenital heart disease (CHD) adults has increased in the past decades due to a longer life expectancy of this population where the subjects are exposed to cardiac overflow, overpressure and structural changes for years. The literature regarding AF ablation in repaired CHD adults emphasizes the importance of intracardiac echocardiography (ICE) to perform the transseptal puncture and the ablation procedure in the left atrium (LA), both effectively and safely. In small case control studies, where the predominant congenital cardiomyopathy was the atrial septal defect, the most common strategy for ablation was antral isolation of the pulmonary veins showing results, at one year follow-up, similar to those in the general population. The positive results of AF ablation so far, in this specific population, widen the range of therapeutic options for a group of patients whose only chance has been pharmacological treatment, which has proved to be inefficacious in most of the cases and not free from adverse events.
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Affiliation(s)
- Marta Acena
- Heart Disease Institute, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital
| | - Ignasi Anguera
- Heart Disease Institute, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital
| | - Paolo D Dallaglio
- Heart Disease Institute, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital
| | - Marcos Rodriguez
- Heart Disease Institute, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital
| | - Xavier Sabaté
- Heart Disease Institute, Bellvitge Biomedical Research Institute-IDIBELL, Bellvitge University Hospital
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20
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Zhou GB, Hu JQ, Guo XG, Liu X, Yang JD, Sun Q, Ma J, Ouyang FF, Zhang S. Very long-term outcome of catheter ablation of post-incisional atrial tachycardia: Role of incisional and non-incisional scar. Int J Cardiol 2015; 205:72-80. [PMID: 26720044 DOI: 10.1016/j.ijcard.2015.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/08/2015] [Accepted: 12/12/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND The arrhythmogenicity of right atrial (RA) incisional scar after cardiac surgery could result in atrial tachycardia (AT). Radiofrequency catheter ablation is effective in the treatment of such tachycardia. However, data regarding long-term outcomes are limited. METHODS AND RESULTS A total of 105 patients with prior RA incision who underwent radiofrequency catheter ablation of AT were included. In the first procedure, electroanatomic mapping (EAM) revealed a total of 139 ATs in 105 patients, including 88 cavotricuspid isthmus dependent atrial flutters (IDAFs), 5 mitral annulus reentrant tachycardias (MARTs), 44 intra-atrial reentrant tachycardias (IARTs) and 2 focal ATs (FATs). AT was successfully eliminated in 101 (96.1%) patients. During a mean follow-up period of 90 ± 36 months, recurrent AT was observed in 23 patients and 21 underwent a second ablation. A total of 23 ATs were identified in redo procedures including 4 IDAFs, 2 MARTs, 12 IARTs and 5 FATs. The time to recurrence was significantly different among various AT types. Acute success was achieved in 20 of 23 redo procedures. Taking a total of 21 patients presenting atrial fibrillation during follow-up into account, 85 patients (81.9%) were in sinus rhythm. No complications except for a case of RA compartmentation occurred. CONCLUSION RA incisional scar played an essential role in promoting both IDAF and IART, while non-incisional scar contributed to a substantial rate of late recurrent AT in forms of both macroreentry and small reentry. Catheter ablation using EAM system resulted in a high success rate during long-term follow-up.
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Affiliation(s)
- Gong-Bu Zhou
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji-Qiang Hu
- Department of Cardiology, Oriental Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Gang Guo
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xu Liu
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian-du Yang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qi Sun
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jian Ma
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Fei-Fan Ouyang
- Department of Cardiology, Asklepios Klinik St Georg, Hamburg, Germany
| | - Shu Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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21
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Lindsay I, Moore JP. Cardiac Arrhythmias in Adults With Congenital Heart Disease: Scope, Specific Problems, and Management. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2015; 17:56. [DOI: 10.1007/s11936-015-0418-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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