Para-Hisian atrial tachycardia ablation in a patient with congenitally corrected transposition of great vessels

Roca‐Luque, Ivo; Rivas, Núria Muñoz; Francisco, Jaume; Pérez-Rodón, Jordi; Dos, Laura; Moya, Àngel; Garcı́a-Dorado, David

doi:10.1016/j.hrcr.2017.04.010

Cited by 5 publications

(6 citation statements)

References 10 publications

(17 reference statements)

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“…So far, four previous reports have highlighted the origin of septal AT from posterior pulmonary valve synus in patients with ccTGA. 1 , 2 , 3 , 4 In these small case series, an EAS from −40 to −80 ms was localized into the pulmonary valve sinus. Double potentials were also noted.…”

Section: Discussionmentioning

confidence: 65%

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Atrial tachycardia ablation through the sub‐pulmonary ventricle in a patient with multiple malformations associated with congenitally corrected transposition of the great arteries and double‐sided slow‐pathway

Preda,

Testoni,

Baroni

et al. 2024

Clinical Case Reports

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Key Clinical MessageA 46‐year‐old woman with congenitally corrected transposition of the great arteries (ccTGA) associated with dextrocardia, situs viscerus inversus, and left superior vena cava persistence presented with an incessant supraventricular tachycardia. Electrophysiological study was not conclusive in differential diagnosis of atrial tachycardia versus atypical atrioventricular (AV) nodal reentrant tachycardia, also due to the unconventional anatomy of the coronary sinus. By a comprehensive mapping of cardiac chambers, a double side slow‐pathway was localized in both atrial chambers and subsequently ablated by radiofrequency delivery without tachycardia changes. Aortic root and cusps were devoid of electrical activity. The muscular part of the sub‐pulmonary ventricle at the level of interatrial septum showed an earliest activation signal of −90 ms and ablation of this site was effective in abolish the tachycardia. This is the first case to report technical concerns of septal atrial tachycardia ablation in ccTGA associated with multiple anatomical malformations. Moreover, some peculiarities have been reported for the first time including the presence of double‐side AV nodal slow‐pathway and atypical localization of the tachycardia origin into the muscular part of the sub‐pulmonary ventricle instead of posterior pulmonary cusp.

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Section: Discussionmentioning

confidence: 65%

“…EAS of this site was significantly earlier than the atrial septal ones. So far, four previous reports have highlighted the origin of septal AT from posterior pulmonary valve synus in patients with ccTGA 1–4 . In these small case series, an EAS from −40 to −80 ms was localized into the pulmonary valve sinus.…”

Section: Discussionmentioning

confidence: 82%

Atrial tachycardia ablation through the sub‐pulmonary ventricle in a patient with multiple malformations associated with congenitally corrected transposition of the great arteries and double‐sided slow‐pathway

Preda,

Testoni,

Baroni

et al. 2024

Clinical Case Reports

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“…Several studies have previously reported the electrocardiogram and electrophysiological features as well as successful ablation of focal ATs only in patients with {S, L, L}-type ccTGA. 1 , 2 , 3 , 4 The majority of ATs shared the common features of anteroseptal ATs, eg, comparatively narrow P wave, positive in leads I and aVL, negative/positive in leads V 1 -V 2 , and negative/positive or isoelectric in inferior leads. 1 The P wave during AT was relatively narrower in the present case.…”

Section: Discussionmentioning

confidence: 95%

“…It is to be noted that previous studies 1 , 2 , 3 , 4 emphasized the importance of mapping and ablation in the pulmonic valve and beyond. For one reason, in patients with ccTGA, the anatomical structure is unique, with the pulmonary artery instead of the aorta in close anatomical relation to the paraseptal region.…”

Section: Discussionmentioning

confidence: 96%

Atrial tachycardia ablation from the pulmonic valve in a patient with congenitally corrected transposition of great arteries

Xie

Guo

et al. 2022

HeartRhythm Case Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Less frequently, ATs may also manifest a focal pattern (5%–10% of cases) ( 2 , 68 , 69 ). Electrocardiographically, they are often indistinguishable from MRAT and the diagnosis is typically established during mapping in the electrophysiology study (EPS).…”

Section: Specific Arrhythmia Typesmentioning

confidence: 99%

Tachyarrhythmias in congenital heart disease

Francisco-Pascual,

Mallofré Vila,

Santos-Ortega

et al. 2024

Front. Cardiovasc. Med.

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The prevalence of congenital heart disease (CHD) in adult patients has risen with advances in diagnostic and surgical techniques. Surgical modifications and hemodynamic changes increase the susceptibility to arrhythmias, impacting morbidity and mortality rates, with arrhythmias being the leading cause of hospitalizations and sudden deaths. Patients with CHD commonly experience both supraventricular and ventricular arrhythmias, with each CHD type associated with different arrhythmia patterns. Macroreentrant atrial tachycardias, particularly cavotricuspid isthmus-dependent flutter, are frequently reported. Ventricular arrhythmias, including monomorphic ventricular tachycardia, are prevalent, especially in patients with surgical scars. Pharmacological therapy involves antiarrhythmic and anticoagulant drugs, though data are limited with potential adverse effects. Catheter ablation is preferred, demanding meticulous procedural planning due to anatomical complexity and vascular access challenges. Combining imaging techniques with electroanatomic navigation enhances outcomes. However, risk stratification for sudden death remains challenging due to anatomical variability. This article practically reviews the most common tachyarrhythmias, treatment options, and clinical management strategies for these patients.

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Para-Hisian atrial tachycardia ablation in a patient with congenitally corrected transposition of great vessels

Cited by 5 publications

References 10 publications

Atrial tachycardia ablation through the sub‐pulmonary ventricle in a patient with multiple malformations associated with congenitally corrected transposition of the great arteries and double‐sided slow‐pathway

Atrial tachycardia ablation through the sub‐pulmonary ventricle in a patient with multiple malformations associated with congenitally corrected transposition of the great arteries and double‐sided slow‐pathway

Atrial tachycardia ablation from the pulmonic valve in a patient with congenitally corrected transposition of great arteries

Tachyarrhythmias in congenital heart disease

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