Intracardiac Echo‐Guided Radiofrequency Catheter Ablation of Atrial Fibrillation in Patients with Atrial Septal Defect or Patent Foramen Ovale Repair: A Feasibility, Safety, and Efficacy Study

Lakkireddy, Dhanunjaya; Rangisetty, Umamahesh; Prasad, Subramanya K.; Biria, Mazda; Berenbom, Loren; Pimentel, Rhea; Emert, Martin; Rosamond, Thomas; Fahmy, Tamer S.; Patel, Dimpi; Biase, Luigi Di; Schweikert, Robert A.; Burkhardt, David

doi:10.1111/j.1540-8167.2008.01249.x

Cited by 76 publications

(53 citation statements)

References 35 publications

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“…12 The success rate of the procedure is similar between patients with ASD and patients without ASD, and between patients who had LA access through the native septum compared with patients who had access through the device. 11,12 Arrhythmia-free survival rates >14 months after the procedure in patients with ASD range between 56 % and 77 %, and are not significantly different from those seen in patients without ASD undergoing catheter ablation for AF.…”

Section: Diagnostic Ablation and Electrophysiologymentioning

confidence: 99%

“…11 However, when the LA is accessed through the occlusion device, more time is required to puncture and dilate the device to allow the transseptal sheath to pass, and as such total procedure time, fluoroscopy time and transseptal time are significantly increased compared with access through the native septum. 12 The success rate of the procedure is similar between patients with ASD and patients without ASD, and between patients who had LA access through the native septum compared with patients who had access through the device.…”

Section: Diagnostic Ablation and Electrophysiologymentioning

confidence: 99%

“…All reported complications resolved and patients achieved full recovery. 11,12 Therefore radiofrequency catheter ablation for AF is a technically feasible procedure in patients with ASD closure devices. Efficacy is similar to that in patients without ASD, and it is a safe procedure with minimal complications.…”

Section: -12mentioning

confidence: 99%

“…Then the dilator was removed and a larger dilator (11 Fr in this case) introduced over the wire. This sequential dilation allowed the transseptal catheter to be advanced through the stiff closure device into the LA.…”

Section: Diagnostic Ablation and Electrophysiologymentioning

confidence: 99%

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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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Section: Diagnostic Ablation and Electrophysiologymentioning

confidence: 99%

Section: Diagnostic Ablation and Electrophysiologymentioning

confidence: 99%

Section: -12mentioning

confidence: 99%

Section: Diagnostic Ablation and Electrophysiologymentioning

confidence: 99%

See 2 more Smart Citations

Ablation of Atrial Fibrillation in Patients with Congenital Heart Disease

Refaat

Ballout

Mansour

2017

Arrhythmia &Amp; Electrophysiology Review

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show abstract

“…However, in the majority of cases transseptal puncture can be safely performed alongside or occasionally through the device under transoesophageal or intracardiac echo guidance (see Figure 1). 17,18 Retrograde transaortic approach with the support of magnetic navigation is an alternative route when transseptal puncture is not possible. 19 As the original disease and its surgical correction get more complex, the likelihood of a more complex intra-atrial re-entrant tachycardia (IART) increases.…”

Section: Macro Re-entrant Atrial Tachycardias and Atrial Fluttermentioning

confidence: 99%

Ablation of Arrhythmias in Patients with Adult Congenital Heart Disease

Lobo¹,

Griffith²,

Bono³

2011

Arrhythmia &Amp; Electrophysiology Review

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Arrhythmias in adults with congenital heart disease, most commonly related to previous surgical procedures, are a frequent comorbidity in this growing population thanks to the improved outcome of surgical techniques. Re-entrant circuits around areas of scarring and natural barriers, combined with abnormal haemodynamics and the underlying anatomy, are the most common cause for these arrhythmias. They are often poorly tolerated and medical treatment is frequently inadequate. In recent years, catheter ablation has emerged as a successful therapeutic option. New advanced techniques such as the use of modern three-dimensional (3D) navigation systems have contributed to better understanding of the arrhythmia mechanisms and higher success rates of the ablation procedures.In this article we briefly summarise the characteristics of the most common arrhythmias in this patient population and some key aspects in their treatment by catheter ablation.

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Retrograde aortic approach for atrial fibrillation ablation with a conventional 3‐D mapping catheter: A case report

Comandante

Chang

Huang

et al. 2019

Clinical Case Reports

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Key Clinical Message The presence of a Gore‐Tex patch can create difficulty in performing transeptal puncture for atrial septal defect patients underwent atrial fibrillation ablation. The maneuverability and stability of using manually operated catheters via retrograde aortic approach could be overcome by a large‐curved catheter to form a loop facilitating approachability to all parts of left atrium.

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Intracardiac Echo‐Guided Radiofrequency Catheter Ablation of Atrial Fibrillation in Patients with Atrial Septal Defect or Patent Foramen Ovale Repair: A Feasibility, Safety, and Efficacy Study

Abstract: Percutaneous AF ablation using double transseptal access is feasible, safe, and efficacious in patients with ASD and PFO repairs.

Cited by 76 publications

References 35 publications

Ablation of Atrial Fibrillation in Patients with Congenital Heart Disease

Ablation of Atrial Fibrillation in Patients with Congenital Heart Disease

Ablation of Arrhythmias in Patients with Adult Congenital Heart Disease

Retrograde aortic approach for atrial fibrillation ablation with a conventional 3‐D mapping catheter: A case report

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