Extensive scar modification for the treatment of intra-atrial re-entrant tachycardia in patients after congenital heart surgery.

Cardiology in the Young
Astrid A HendriksTamas Szili-Torok

Abstract

Catheter ablation is an important therapeutic option for atrial tachycardias in patients with CHD. As a result of extensive scarring and surgical repair, multiple intra-atrial re-entrant tachycardia circuits develop and serve as a substrate for arrhythmias. The best ablation approach for patients with multiple intra-atrial re-entrant tachycardias has not been investigated. Here, we compared substrate-based ablation using extensive scar modification to conventional ablation. The present study included patients with surgically corrected CHD that underwent intra-atrial re-entrant tachycardia ablation. Extensive scar modification was defined as substrate ablation based on a dense voltage map, aimed to eliminate all potentials in the scar region. The control group had activation mapping-based ablation. A clinical composite endpoint was assessed. Points were given for type, number, and treatment of intra-atrial re-entrant tachycardia recurrence. In 40 patients, 63 (extensive scar modification 13) procedures were performed. Acute procedural success was achieved in 78%. Procedural duration was similar in both groups. Forty-nine percent had a recurrence within 1 year. During a 5-year follow-up (2.5-7.5 years), 46% required repeat cathet...Continue Reading

References

Jan 31, 2007·Circulation·Edward P Walsh, Frank Cecchin
Aug 26, 2014·Circulation. Arrhythmia and Electrophysiology·Sascha RolfChristopher Piorkowski
Sep 28, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Pasquale Santangeli, Francis E Marchlinski
Jan 1, 2016·Journal of the American College of Cardiology·Luigi Di BiaseAndrea Natale

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