Ablation of atrial tachyarrhythmias late after surgical repair of tetralogy of Fallot

Raine, Dan; O’Sullivan, John; Chaudhari, Milind; Hamilton, Leslie; Hasan, Asif; Bourke, John

doi:10.1017/s1047951110001447

Cited by 4 publications

(7 citation statements)

References 11 publications

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“…Mechanisms and outcomes have only been described in a small number of previous studies. [12][13][14] De Groot et al 12 described a comparable large proportion of cavo-tricuspid isthmus-dependent tachycardia with scar-dependent intra-atrial re-entrant tachycardia, and similarly reported acute success rates of 98% with sinus rhythm maintained in~85% at long-term follow-up. They also observed a similar incidence of atrial fibrillation during follow-up but did not describe left atrial ablation in their patients.…”

Section: Discussionmentioning

confidence: 98%

Radiofrequency ablation of atrial tachyarrhythmias in adults with tetralogy of Fallot – predictors of success and outcome

et al. 2016

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Patients with tetralogy of Fallot and atrial tachyarrhythmias have more dilated atria than those without atrial tachyarrhythmias. Radiofrequency ablation improves functional status. Left atrial ablation is more commonly required with repeat procedures. There is a high prevalence of atrial tachyarrhythmias, particularly atrial fibrillation, in patients with tetralogy of Fallot; early radiofrequency ablation may have a protective effect against this.

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Section: Discussionmentioning

confidence: 98%

Radiofrequency ablation of atrial tachyarrhythmias in adults with tetralogy of Fallot – predictors of success and outcome

et al. 2016

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“…26,27 Given the complex atrial substrate in the patient with TOF, a hybrid approach consisting of medications, pacing, and further surgery tailored to the individual may be required. 17…”

Section: Ablationmentioning

confidence: 99%

“…6,22–24 Multiple AA mechanisms may coexist in the same patient and typically involve a combination of the cavotricuspid isthmus, scar-based macroreentrant tachycardia, or a focal atrial tachycardia, thereby requiring complex ablations. 11,17,18,25…”

Section: Atrial Tachyarrhythmias and Sinus Node Dysfunctionmentioning

confidence: 99%

“…Catheter ablation in patients with TOF can reduce AA frequency, can improve symptoms, and can be an effective treatment option when performed by specialists familiar with TOF anatomy. [17][18][19][20] Cavotricuspid isthmusdependent AFL and right atriotomy scar account for the majority of intra-atrial reentrant tachycardia in TOF. Cather ablation of AFL or interatrial reentrant tachycardia has a high success rate and low recurrence rate, although some patients require a second procedure.…”

Section: Ablationmentioning

confidence: 99%

“…6, [22][23][24] Multiple AA mechanisms may coexist in the same patient and typically involve a combination of the cavotricuspid isthmus, scar-based macroreentrant tachycardia, or a focal atrial tachycardia, thereby requiring complex ablations. 11,17,18,25 Arrhythmia Surgery Surgical AA ablation at the time of pulmonary valve replacement (PVR) may decrease future arrhythmia risk and may be considered on the basis of individual scenarios with a multidisciplinary heart team. 26,27 Given the complex atrial substrate in the patient with TOF, a hybrid approach consisting of medications, pacing, and further surgery tailored to the individual may be required.…”

Section: Ablationmentioning

confidence: 99%

See 2 more Smart Citations

Arrhythmias in Repaired Tetralogy of Fallot: A Scientific Statement From the American Heart Association

Krieger¹,

Zeppenfeld²,

DeWitt³

et al. 2022

Circ: Arrhythmia and Electrophysiology

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Arrhythmia and sudden cardiac death remain common in repaired tetralogy of Fallot and affect even those with excellent anatomic repairs. Atrial arrhythmia often has mechanisms different from those in acquired heart disease. Ventricular arrhythmia remains a major source of mortality in repaired tetralogy of Fallot. Noninvasive risk stratification is important to identify patients who may benefit from ablation or primary prevention implantable cardioverter defibrillators. Multiple noninvasive risk factors are associated with ventricular arrhythmia, but no universally accepted risk stratification algorithm exists. The mechanism of ventricular arrhythmia is usually attributable to a consistent and discrete set of slowly conducting anatomic isthmuses related to both the native anatomy and the consequences of the surgical repair, which interact with ventricular remodeling to provide arrhythmic substrate. This substrate can be identified during electroanatomic mapping and prophylactically ablated in appropriate patients. This scientific statement discusses the mechanisms and treatment of arrhythmia in repaired tetralogy of Fallot.

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A Narrative Review of Postoperative Anticoagulation Therapy for Congenital Cardiac Disease

et al. 2022

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Congenital heart disease encompasses a range of cardiac birth defects. Some defects require early and complex surgical intervention and post-operative thromboprophylaxis primarily for valve, conduit, and shunt patency. Antiplatelet and anticoagulant management strategies vary considerably and may or may not align with recognized consensus practice guidelines. In addition, newer anticoagulant agents are being increasingly used in children, but these medications are not addressed in most consensus statements.This narrative review evaluated the literature from 2011 through 2021 on the topic of postoperative thromboprophylaxis after congenital heart disease operations. The search was focused on the descriptions and results of pediatric studies for replacement and/or repair of heart valves, shunts, conduits, and other congenital heart disease operations. Wide variability in practice exists and, as was true a decade ago, few randomized controlled trials have been conducted. Aspirin, warfarin, and perioperative heparin remain the most commonly used agents with varying dosing, duration, and monitoring strategies, making comparisons difficult. Only recently have data on direct oral anticoagulants been published in children, suggesting evolving paradigms of care. Our findings highlight the need for more research to strengthen the evidence for standardized thromboprophylaxis strategies.

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Ablation of atrial tachyarrhythmias late after surgical repair of tetralogy of Fallot

Cited by 4 publications

References 11 publications

Radiofrequency ablation of atrial tachyarrhythmias in adults with tetralogy of Fallot – predictors of success and outcome

Radiofrequency ablation of atrial tachyarrhythmias in adults with tetralogy of Fallot – predictors of success and outcome

Arrhythmias in Repaired Tetralogy of Fallot: A Scientific Statement From the American Heart Association

A Narrative Review of Postoperative Anticoagulation Therapy for Congenital Cardiac Disease

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