Risk factors for atrial tachyarrhythmias after the fontan operation

Gelatt, Mark; Hamilton, Robert M.; McCrindle, Brian W.; Gow, Robert M.; Williams, William G.; Trusler, George A.; Freedom, Robert M.

doi:10.1016/0735-1097(94)90181-3

Cited by 241 publications

(103 citation statements)

References 18 publications

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“…W długoterminowej obserwacji większe prawdopodobieństwo występowania tachyarytmii przedsionkowych dotyczy pacjentów z zespoleniami przedsionkowo-płucnymi (być może z powodu większej objętości przedsionka i przeciążenia ciśnieniowego) [980]. Tachyarytmie przedsionkowe mogą być również pierwszym objawem upośledzenia drożno-ści zespolenia przedsionkowo-płucnego -powikłania, które musi zostać wykryte.…”

Section: Tachyarytmie Przedsionkowe Po Operacji Z Wytworzeniem Krążenunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,331

4,193

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Section: Tachyarytmie Przedsionkowe Po Operacji Z Wytworzeniem Krążenunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,331

4,193

View full text Add to dashboard Cite

“…Their baseline hemodynamic state is precarious, with limited oxygen reserves and a high viscosity state. [23] If patients with CHD develop AF, they are more likely to have substantial morbidity due to poorly tolerated rapid rates and thromboembolic events. Compared with patients who do not have CHD, patients with CHD develop AF at a younger age, and their AF is more challenging to manage medically, minimally invasively, or surgically.…”

Section: Featured Review Journal Of Atrial Fibrillationmentioning

confidence: 99%

Atrial Fibrillation in Patients with Congenital Heart Disease

Moe

Abrich

Rhee

2017

Journal of Atrial Fibrillation

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“…Among patients with RA-PA connection that was performed in the past, the proportion of patients with supraventricular arrhythmia at 20 years after the surgery may be as high as 50% [12,13]. In case of LT that was performed during a later period and currently preferred ECC, these proportions are 6-35% and 2-28%, respectively [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

Atrial tachycardia ablation in patients with a functional single ventricle after the Fontan surgery

et al. 2016

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A b s t r a c tBackground: Atrial tachyarrhythmias are a leading source of morbidity and mortality after Fontan-type procedures and antiarrhythmic drug therapy is often ineffective in these patients. Aim:To evaluate short-and long-term outcomes of radiofrequency current ablation for atrial tachycardia (AT) in patients after the Fontan procedure, and to report clinical, electrophysiological and electroanatomical characteristics of these arrhythmias. Methods:We retrospectively analysed data obtained in 8 patients (5 males, 3 females) after the Fontan procedure who underwent ablation for AT between 2002 and 2013. In order to compare the clinical impact of arrhythmia before and after ablation, we used the modified arrhythmia score, ranging from 0 (no arrhythmia activity) to 12 (very severe arrhythmia). In all patients, electroanatomical mapping using the CARTO system was performed, allowing semiquantification of low-voltage (< 0.5 mV) areas and scars.Results: Seven patients had an atriopulmonary connection and 1 patient had an extracardiac conduit. The mean patient age was 9.4 ± 3.1 years at the time of the Fontan procedure and 26.2 ± 4.6 years at the time of the first ablation. A total of 18 ablations were performed with no complications, 1 to 4 (median 2.5) procedures per patient. In patients who had more than 1 ablation, the mean time from the first to the last procedure was 34.8 months (range 1-64 months). In individual patients, 1 to 4 (median 2.5) different ATs were observed, with the mean tachycardia cycle length of 334 ± 95 ms. In 6 patients, low-voltage area (< 0.5 mV) comprised 25-50% of the right atrium, and in two others it comprised 10-25% and < 10% of the right atrium, respectively. Seven procedures were fully successful (ablation of all ATs), 7 were partially successful (ablation of only some AT, including clinical arrhythmia, but not of all ATs) and 4 were unsuccessful (failed ablation of clinical AT). The mean procedural, fluoroscopy and ablation times were 176 ± 54.6, 13.7 ± 5.7 and 21.7 ± 11.9 min, respectively. Freedom from arrhythmia during the mean follow-up of 58.6 ± 46 months (range 11-127 months) since the last procedure was obtained in 4 patients. The median arrhythmia score after the last ablation was significantly reduced compared to baseline (4.5 vs. 8; p < 0.05).Conclusions: Catheter ablation of AT in patients after the Fontan procedure is safe but its acute and long-term efficacy is limited. Due to complex and extensive substrate, along with complex anatomy, recurrences are frequent and patients may require repeat ablation procedures. Suppression of arrhythmia is associated with an improved clinical status of the patients.

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Risk factors for atrial tachyarrhythmias after the fontan operation

Abstract: Early postoperative atrial tachyarrhythmias, length of follow-up and atriopulmonary connection are significant independent risk factors for the presence of late atrial tachyarrhythmias.

Cited by 241 publications

References 18 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Atrial Fibrillation in Patients with Congenital Heart Disease

Atrial tachycardia ablation in patients with a functional single ventricle after the Fontan surgery

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