Antitachycardia Pacemakers in Congenital Heart Disease

Kamp, Anna; LaPage, Martin J.; Serwer, Gerald A.; Dick, Macdonald; Bradley, David J.

doi:10.1111/chd.12230

Cited by 16 publications

(5 citation statements)

References 14 publications

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“…However, the follow‐up duration in these case reports is limited – 9 months, 15 unreported 16,17 . Although there may be an increased incidence of atrial fibrillation in adults with structurally normal hearts and antitachycardia pacemakers, 18 the ATP literature in congenital heart disease has not demonstrated an increase in atrial fibrillation 12–14 . In addition, increased atrial fibrillation was not observed in our case series or the TPARx case reports referenced above.…”

Section: Discussionmentioning

confidence: 66%

“…7,11 More recently, ATP has been shown to be a relatively safe and effective therapy for many ACHD patients with IART. [12][13][14] The programmed antitachycardia pacemaker algorithm for Medtronic devices is designed to deliver therapy for atrial arrhythmias with ≥2:1 atrioventricular (AV) conduction. The pacemaker will not recognize IART with 1:1 AV conduction, which is seen in many adults with congenital heart disease.…”

Section: Introductionmentioning

confidence: 99%

“…Early experience with atrial ATP in pediatric and congenital heart disease was complicated by proarrhythmic effects and inability to provide rate‐responsive pacing or AV sequential pacing 7,11 . More recently, ATP has been shown to be a relatively safe and effective therapy for many ACHD patients with IART 12–14 …”

Section: Introductionmentioning

confidence: 99%

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Patient‐activated anti‐tachycardia pacing in adult congenital heart disease

Carberry

Tsao

Chaouki

2022

Pacing Clinical Electrophis

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Introduction In adults with congenital heart disease, intra‐atrial reentrant tachycardia (IART) is a common arrhythmia that causes significant morbidity and mortality. One treatment option for IART is antitachycardia pacing. Atrial antitachycardia pacing algorithms deliver therapy for IART with ≥2:1 conduction, but most algorithms will not recognize IART with 1:1 conduction. Temporary Patient Activated Rx (TPARx) is Medtronic software that can be installed in antitachycardia pacemakers allowing patients to deliver therapies on demand for IART with 1:1 conduction. Methods Retrospective chart review at a single institution of all patients who had TPARx installed into their pacemaker. Results Four adults with single ventricle congenital heart disease and IART underwent Fontan conversion, arrhythmia surgery, and placement of an epicardial dual‐chamber antitachycardia pacemaker. They had recurrent IART with a long cycle length and 1:1 conduction that failed to trigger antitachycardia pacing therapies. TPARx software was programmed into their pacemakers to allow recognition and treatment of IART with 1:1 conduction. Mean follow‐up duration after TPARx programming was 4.9 years. Each patient received at least one successful antitachycardia pacing therapy via TPARx – range 0.4–26 treated IART episodes per year. There were no atrial or ventricular arrhythmias induced with antitachycardia pacing. Two patients were able to discontinue anticoagulation after TPARx installation. Conclusion This series demonstrates the use of TPARx software as part of a long‐term IART management strategy in select patients with IART who have failed more conventional therapies.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

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Patient‐activated anti‐tachycardia pacing in adult congenital heart disease

Carberry

Tsao

Chaouki

2022

Pacing Clinical Electrophis

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“…In selected patients with interatrial reentrant tachycardia who require pacing for bradyarrhythmia, antitachycardia pacing can serve as adjuvant therapy to ablation or antiarrhythmic drugs and may reduce the need for cardioversion. 30,31…”

Section: Bradyarrhythmiamentioning

confidence: 99%

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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“…1 Crucial surgical and medical advancements have significantly extended life expectancies; however, cardiac arrhythmias such as intraatrial reentrant tachycardia (IART) are common in adults with surgically repaired CHD. 2 IART is defined as any macrorentrant atrial tachycardia that is not necessarily dependent on the cavotricuspid isthmus. 3 In CHD patients, IART significantly increases morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%