Interventional Electrophysiology in Patients With Congenital Heart Disease

Walsh, Edward P.

doi:10.1161/circulationaha.106.655753

Cited by 153 publications

(86 citation statements)

References 115 publications

(83 reference statements)

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“…27 For Fontan patients who have AF, the atrial MAZE can be extended to the LA with a variation of the Cox procedure and with a recurrence rate <12 %.…”

Section: Other Congenital Heart Defectsmentioning

confidence: 99%

Ablation of Atrial Fibrillation in Patients with Congenital Heart Disease

Refaat

Ballout

Mansour

2017

Arrhythmia &Amp; Electrophysiology Review

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Although there is no formal database of adults with congenital heart disease (CHD) in the United States, the prevalence and incidence of CHD can be estimated and extrapolated from data in the Canadian providence.1 As such, the prevalence of CHD in the United States has been estimated in 2010 to be around 2.4 million people (1.4 million adults and 1 million children), with an incidence of between four and 10 per 1,000. Forty-five per cent of these adults have mild disease, 37 % have moderate disease, and 14 % have severe disease. 1-3 Furthermore, the prevalence of patients living with CHD has been increasing secondary to the improvements in surgical techniques and medical management over the past few decades. Mortality secondary to CHD is highest during infancy and childhood declining gradually with age to reach a steady state between 15 and 65 years. It is higher in men than women. 4One of the most important causes of morbidity in patients with CHD is the development of cardiac arrhythmias, in particular tachyarrhythmias.These result from multiple surgical scars, haemodynamic abnormalities and structural defects that create arrhythmogenic substrates. 5 In fact, about 11 % of patients with CHD develop atrial arrhythmias (intra-atrial reentrant tachycardia [IART] and AF), with the risk being higher in patients with right-sided heart lesions. 6 The most common arrhythmia in patients with CHD is IART that occurs secondary to reentrant circuits in the right atrium. AF is a less common cause of atrial arrhythmia in CHD, but its prevalence is increasing in these patients because of improved survival to older age. AbstractWith improved surgical techniques and medical management for patients with congenital heart diseases, more patients are living longer and well into adulthood. This improved survival comes with a price of increased morbidity, mainly secondary to increased risk of tachyarrhythmias. One of the major arrhythmias commonly encountered in this subset of cardiac patients is AF. Similar to the general population, the risk of AF increases with advancing age, and is mainly secondary to the abnormal anatomy, abnormal pressure and volume parameters in the hearts of these patients and to the increased scarring and inflammation seen in the left atrium following multiple surgical procedures. Catheter ablation for AF has been shown to be a very effective treatment modality in patients with refractory AF.However, data and guidelines regarding catheter ablation in patients with congenital heart disease are not well established. This review will shed light on the procedural techniques, success rates and complications of AF catheter ablation in patients with different types of CHD, including atrial septal defects, tetralogy of Fallot, persistent left superior vena cava, heterotaxy syndrome and atrial isomerism, and Ebstein anomaly. KeywordsAtrial fibrillation, catheter ablation, congenital heart disease, atrial septal defect, tetralogy of Fallot, persistent left superior vena cava, Ebstein anomaly, atrial isomerism Discl...

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“…27 For Fontan patients who have AF, the atrial MAZE can be extended to the LA with a variation of the Cox procedure and with a recurrence rate <12 %.…”

Section: Other Congenital Heart Defectsmentioning

confidence: 99%

Ablation of Atrial Fibrillation in Patients with Congenital Heart Disease

Refaat

Ballout

Mansour

2017

Arrhythmia &Amp; Electrophysiology Review

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“…Percutaneous treatment of these arrhythmias is often limited by inability to access the appropriate cardiac chamber and has had only variable success (Walsh, 2007).…”

Section: The Failing Fontanmentioning

confidence: 99%

Surgical Maze Procedures for Atrial Arrhythmias in Univentricular Hearts, from Maze History to Conversion-Fontan

Kik¹,

Bogers²

2012

Tachycardia

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“…Other risk factors have to be taken into account before deciding to implant an ICD (Triedman 2008). With the increasing knowledge of rhythm abnormalities in congenital heart disease and the emergence of interventional electrophysiologic techniques some ventricular arrhythmias can be treated by catheter ablation (Walsh 2007). ICD implantation remains to be limited to otherwise untreatable rhythm abnormalities.…”

Section: Congenital Heart Diseasementioning

confidence: 99%