Key result
Transcatheter ablation and EP procedures revolutionize arrhythmia management in complex CHD through higher procedural success.
Transcatheter ablation is a crucial and evolving therapy for managing arrhythmias in patients with complex congenital heart disease, overcoming limitations of lifelong pharmacologic therapy.
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May support ablation over pharmacotherapy in complex CHD; leaves open need for prospective trials to guide practice.
Arrhythmias are responsible for significant morbidity and mortality in patients with complex congenital heart disease (CHD). Pharmacologic antiarrhythmic therapy often proves ineffective or intolerable due to adverse side effect profile in a patient group consigned to lifelong treatment. Interventional electrophysiology procedures have revolutionized arrhythmia management in the CHD population since the introduction of transcatheter ablation in the late 1980s. Tremendous advances in electroanatomic mapping and ablation technology have led to increased procedural success in conjunction with a dramatically reduced risk profile to overcome the challenges of patient size, abnormalities of the intrinsic conduction system, mapping of arrhythmia in complex congenital cardiac malformations and limited access to surgically isolated cardiac chambers. Future interventional electrophysiology innovations are geared to provide further reduction in radiation exposure for the CHD population.
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Grant et al. (2015) conducted a review in Arrhythmias in complex congenital heart disease. Transcatheter ablation and interventional electrophysiology procedures was evaluated. Transcatheter ablation and interventional electrophysiology procedures have revolutionized arrhythmia management in patients with complex congenital heart disease by increasing procedural success.
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