What does this research mean for the field?

Intra-atrial reentrant tachycardia (IART) following congenital heart surgery utilizes diverse activation circuits and is anatomically distinct from common atrial flutter. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To determine the anatomic substrates and electrophysiological mechanisms of intra-atrial reentrant tachycardia occurring after surgical repair of congenital heart disease.

March 1, 1997Journal of Cardiovascular ElectrophysiologyOpen Access

Intra‐Atrial Reentrant Tachycardia After Palliation of Congenital Heart Disease:

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Why the study?

What are the mechanisms and activation sequences of intra-atrial reentrant tachycardia following congenital heart surgery?

Population

11 patients, including 8 following congenital heart surgery and 3 with normal intracardiac anatomy.

Design

Case_series

Authors

JTJohn K. TriedmanPediatric Cardiology KJKathy J. JenkinsPediatric Cardiology SCSteven D. ColanPediatric / Congenital Cardiology

Discussion

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Implication

May support individualized ablation planning over typical flutter assumptions; leaves open validation in larger congenital cohorts.

Key Points

To determine the anatomic substrates and electrophysiological mechanisms of intra-atrial reentrant tachycardia occurring after surgical repair of congenital heart disease.
Performed high-density endocardial mapping using a 25-bipolar pair basket catheter combined with digitized biplane fluoroscopy and surface ECG signals to generate dynamic 3D activation maps.
Assessed 8 patients with prior congenital heart repair (5 Fontan, 2 tetralogy of Fallot, 1 ventricular septal defect) and 3 control patients with normal anatomy.
Mapped 10 discrete intra-atrial reentrant tachycardia activation sequences across surgical patients using a median of 108 electrode positions (range, 27 to 197) and 6 recordings per sequence (range, 3 to 11).
Observed heterogeneous tachycardia mechanisms characterized by slow conduction zones, lines of block, and bystander pathways, with only 1 circuit matching classic atrial flutter.

Structured PICO

What are the mechanisms and activation sequences of intra-atrial reentrant tachycardia following congenital heart surgery?

Population

11 patients, including 8 following congenital heart surgery (5 Fontan, 2 tetralogy of Fallot repair, 1 ventricular septal defect repair) and 3 with normal intracardiac anatomy (1 with type I atrial flutter).

Intervention

High-density endocardial mapping using a multipolar basket recording catheter (25 bipolar pairs) to create three-dimensional atrial activation sequence maps.

Outcome

Mechanisms and activation sequences of intra-atrial reentrant tachycardia (IART).surrogate

High-density 3D mapping demonstrates that IART circuits in patients with prior congenital heart surgery are diverse and distinct from typical atrial flutter, which may inform future ablative therapies.

Cite This Study

Triedman et al. (1997) studied this question.

synapsesocial.com/papers/6a154af25347fbb1739f8bc3 https://doi.org/10.1111/j.1540-8167.1997.tb00789.x

Topics

Congenital heart disease adults

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Intra‐Atrial Reentrant Tachycardia After Palliation of Congenital Heart Disease:

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Intra‐Atrial Reentrant Tachycardia After Palliation of Congenital Heart Disease:

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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