Intra-atrial re-entrant tachycardia in patients with congenital heart disease: factors associated with disease severity

Roca‐Luque, Ivo; Gandara, N Rivas; Subirà, Laura Dos; Francisco‐Pascual, Jaume; Pérez-Rodón, Jordi; Pijuan-Domenech, Antònia; Subirana, M; Miranda, Berta; Ortega, A Santos; Ferrer, Jaume; García, David García‐Dorado; Mitjans, Àngel Moya

doi:10.1093/europace/eux180

Cited by 9 publications

(7 citation statements)

References 20 publications

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“…In selected patients with CHD (including those with atrial baffle repair for transposition of the great arteries, Fontan operation and Ebstein anomaly), evaluation and treatment of SVT (such as intra-atrial re-entrant tachycardias or AV re-entrant tachycardias) with rapid ventricular conduction should also be considered. 890,895,896 In the absence of identifiable reversible factors, ICD implantation for secondary prevention of SCD is recommended. 349,350 While transvenous ICD systems have been most frequently used and have the advantage of anti-tachycardia and anti-bradycardia pacing, subcutaneous ICDs may be an alternative in selected patients with limited venous access to the ventricle or with intracardiac shunts.…”

Section: Cmentioning

confidence: 99%

2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Zeppenfeld¹,

Tfelt-Hansen²,

Riva³

et al. 2022

European Heart Journal

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1,111

625

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All experts involved in the development of these guidelines have submitted declarations of interest. These have been compiled in a report and published in a supplementary document simultaneously to the guidelines. The report is also available on the ESC website www.escardio.org/Guidelines See the European Heart Journal online for supplementary data that includes background information and detailed discussion of the data that have provided the basis of the guidelines.Click here to access the corresponding ESC CardioMed chapters.

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Section: Cmentioning

confidence: 99%

2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Zeppenfeld¹,

Tfelt-Hansen²,

Riva³

et al. 2022

European Heart Journal

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1,111

625

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“… 7 , 14 Concerning the tachycardia mechanism, IART was the most induced mechanism (78%), thereof 42% CTI dependent, in comparison with FAT (22%), as has been described often before in the CHD population. 5 , 15 Atrial fibrillation is a growing challenge in the CHD population, as patients grow older and AT often precedes atrial fibrillation. 16 In our study, atrial fibrillation occurred in 13 patients (24%) and 10 of these patients underwent PVI.…”

Section: Discussionmentioning

confidence: 99%

Coherent mapping of atrial tachycardias in patients with congenital heart disease

et al. 2023

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Aims Coherent mapping (CM) uses a new algorithm to identify critical conduction isthmuses of atrial tachycardias (ATs). We analysed our experience of ablation of AT in patients with congenital heart disease (CHD) with this new technology. Methods and results All patients with CHD who had CM of AT using the high-density mapping PENTARAY™ catheter and three-dimensional electroanatomic mapping system Carto3 between June 2019 and June 2021 were included retrospectively (n = 27). As a control group, 27 patients with CHD and mapping of AT without CM between March 2016 and June 2019 were included. In total, 54 ablation procedures were performed in 42 patients [median age 35 (interquartile range, IQR 30–48) years] and 64 ATs were induced and mapped (thereof 50 AT intraatrial re-entrant tachycardia and 14 AT ectopic AT). The median procedure duration was 180 (120–214) min and median fluoroscopy time was 10 (5.2–14) min. Acute success was 100% (27/27) in the Coherence group and 74% (20/27) in the non-Coherence group (P = 0.01). During follow-up [median 26 (12–45) months], AT recurred in 28/54 patients, thereof 15 patients needed a re-ablation procedure. Log-rank test showed no difference in recurrence rate between the two groups (P = 0.29). Three minor complications occurred (5.5%). Conclusion Mapping of AT in patients with CHD using the PENTARAY™ mapping catheter and the CM algorithm led to excellent acute success. All ATs were possible to map and no complications related to the PENTARAY™ mapping catheter were observed. Thus, the use of the CM algorithm represents a promising tool in patients with CHD and complex AT.

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“…A hemodynamic origin of syncope should be suspected in patients with valvular heart disease. However, other causes are possible[ 1 , 5 , 9 , 119 - 123 ]. The valvular heart disease with the highest risk of syncope is AoS[ 5 , 124 , 125 ].…”

Section: Arrhythmic Syncope In Specific Populationsmentioning

confidence: 99%

Arrhythmic syncope: From diagnosis to management

Pascual¹,

Marchite²,

Silva³

et al. 2023

World J Cardiol

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Syncope is a concerning symptom that affects a large proportion of patients. It can be related to a heterogeneous group of pathologies ranging from trivial causes to diseases with a high risk of sudden death. However, benign causes are the most frequent, and identifying high-risk patients with potentially severe etiologies is crucial to establish an accurate diagnosis, initiate effective therapy, and alter the prognosis. The term cardiac syncope refers to those episodes where the cause of the cerebral hypoperfusion is directly related to a cardiac disorder, while arrhythmic syncope is cardiac syncope specifically due to rhythm disorders. Indeed, arrhythmias are the most common cause of cardiac syncope. Both bradyarrhythmia and tachyarrhythmia can cause a sudden decrease in cardiac output and produce syncope. In this review, we summarized the main guidelines in the management of patients with syncope of presumed arrhythmic origin. Therefore, we presented a thorough approach to syncope work-up through different tests depending on the clinical characteristics of the patients, risk stratification, and the management of syncope in different scenarios such as structural heart disease and channelopathies.

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Intra-atrial re-entrant tachycardia in patients with congenital heart disease: factors associated with disease severity

Cited by 9 publications

References 20 publications

2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

2022 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death

Coherent mapping of atrial tachycardias in patients with congenital heart disease

Arrhythmic syncope: From diagnosis to management

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