Catheter ablation for postoperative SVT in patients with univentricular heart achieved a procedural success rate of 78%, with 72% of patients maintaining sinus rhythm at a mean follow-up of 53 months.
Observational (n=19)
Does catheter ablation improve long-term sinus rhythm maintenance in patients with univentricular heart and postoperative SVT?
Catheter ablation is a potentially curative treatment for postoperative SVT in patients with univentricular hearts, achieving long-term sinus rhythm in the majority of patients despite the progressive nature of atrial disease.
BACKGROUND: Catheter ablation has evolved as a possible curative treatment modality for supraventricular tachycardias (SVT) in patients with univentricular heart. However, the long-term outcome of ablation procedures is unknown. We evaluated the procedural and long-term outcome of ablative therapy of late postoperative SVT in patients with univentricular heart. METHODS AND RESULTS: Patients with univentricular heart (n=19, 11 male; age, 29+/-9 years) referred for ablation of SVT were studied. Ablation was guided by 3D electroanatomic mapping in all but 2 procedures. A total of 41 SVT were diagnosed as intra-atrial reentrant tachycardia (n=30; cycle length, 310+/-68 ms), typical atrial flutter (n=4; cycle length, 288+/-42 ms), focal atrial tachycardia (n=6; cycle length, 400+/-60 ms), and atrial fibrillation (n=1). Ablation was successful in 73% of intra-atrial reentrant tachycardia, 75% of atrial flutter, and all focal atrial tachycardia and focal atrial fibrillation. During the follow-up period of 53+/-34 months, 2 patients were lost to follow-up, 3 died of heart failure, 2 underwent heart transplantation, and 1 underwent conduit replacement. Of the remaining group, 8 had sinus rhythm and 3 had SVT. CONCLUSIONS: Focal and reentrant mechanisms underlie postoperative SVT in patients with univentricular heart. Successive SVT developing over time may be caused by different mechanisms. Ablative therapy is potentially curative, with a procedural success rate of 78%. In patients who had multiple ablation procedures, the SVT originated from different atrial sites, suggesting that these new SVT were caused by progressive atrial disease. Despite recurrent SVT, sinus rhythm at the end of the follow-up period was achieved in 72%.
Groot et al. (Mon,) conducted a observational in Postoperative supraventricular tachycardias in patients with univentricular heart (n=19). Catheter ablation was evaluated on Procedural success rate. Catheter ablation for postoperative SVT in patients with univentricular heart achieved a procedural success rate of 78%, with 72% of patients maintaining sinus rhythm at a mean follow-up of 53 months.