Irrigated-tip catheter ablation of intraatrial reentrant tachycardia in patients late after surgery of congenital heart disease
Section snippets
Patient population
The study group consisted of 36 consecutive patients referred to the Swiss Cardiovascular Center Bern and to the Department of Cardiology, Aarhus University Hospital (Skejby), Denmark, for management of intraatrial reentrant tachycardia late after surgery for congenital heart disease. All patients had symptomatic persistent or recurrent intraatrial reentrant tachycardia refractory to antiarrhythmic drug therapy. Patients with predominant atrial fibrillation were excluded from the study. All
Patient characteristics
Thirty-six consecutive patients (26 male [72%]; median age 46 years, range 9–67) with surgically corrected congenital heart disease were studied (Table 1). Cardiac anomalies included tetralogy of Fallot (TOF, n = 8), atrial septal defect (ASD, primum, n = 5; secundum, n = 14), transposition of the great vessels (n = 5), ventricular septal defect (VSD, n = 1), univentricular heart (n = 1), and congenitally corrected transposition of the great vessels with VSD (n = 1). The functional status of
Discussion
This study presents initial experience combining recent advances in electroanatomic mapping with traditional entrainment mapping and lesion formation using irrigated-tip catheters.
Conclusion
Electronanatomic mapping and entrainment mapping allow precise characterization of complex reentrant circuits. Adding catheter irrigation to these mapping techniques allows increased power delivery, particularly to sites with low blood flow. This approach is safe and highly effective for ablation of both typical isthmus-dependent atrial flutter and incisional atrial tachycardia in congenital heart disease patients. The combination of entrainment mapping, electroanatomic mapping, and
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Dr. Lukac was supported by a Training Fellowship from the European Society of Cardiology and a Training Fellowship from the Slovak Society of Cardiology. Dr. Delacretaz was supported by Grant 632-066101 from the Swiss National Research Foundation.
H.T. and P.L. contributed equally to the manuscript.