Key result
Radiofrequency catheter ablation achieved an overall acute success rate of 81% in patients with congenital heart disease, though tachycardia recurrence occurred in 54% over 7.4 years of follow-up.
Why the study?
Does radiofrequency catheter ablation successfully treat atrial tachyarrhythmias across different complexities of congenital heart disease?
Cohort (n=144)
Does radiofrequency catheter ablation successfully treat atrial tachyarrhythmias across different complexities of congenital heart disease?
Radiofrequency ablation for atrial tachycardias in congenital heart disease yields high acute success regardless of anatomical complexity, but long-term recurrence remains high, particularly in patients with complex surgical anatomies.
May support acute ablation use in CHD tachyarrhythmias; leaves open need for strategies to curb high long-term recurrence.
BACKGROUND: Radiofrequency catheter ablation has become the treatment strategy of choice for atrial tachyarrhythmias in patients with congenital heart disease (CHD). We analyzed results of radiofrequency catheter ablation in a large cohort of patients with CHD with special reference to complexity of underlying anatomy. METHODS AND RESULTS: One hundred and forty-four patients with CHD and atrial tachyarrhythmias undergoing radiofrequency catheter ablation were classified according to complexity of underlying CHD: simple CHD, n=18 (12%); moderate CHD, n=53 (37%); and complex CHD, n=73 (51%). Overall acute success was achieved in 81% of the patients. Acute success was lower for tachycardias involving the left atrium compared with right atrial tachycardias. Complexity of CHD was associated with longer procedure duration. Tachycardia recurrence was observed in 54% of the patients after a total follow-up of 7.4 years. 75% of all recurrences occurred within the first year. Recurrence of tachycardia was more likely in patients with complex surgical atrial anatomy (ie, Fontan palliation or atrial switch procedure). Major complications occurred in 4 patients and were related to vascular access. CONCLUSIONS: Acute procedural success of atrial tachycardia ablation in congenital heart patients was not influenced by complexity of CHD. Long-term outcome with regard to tachycardia recurrence was worse in patients with complex surgical atrial anatomy.
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Klehs et al. (2017) conducted a cohort in Congenital heart disease and atrial tachyarrhythmias (n=144). Radiofrequency catheter ablation vs. Complexity of underlying CHD (simple, moderate, complex) was evaluated on Acute success and tachycardia recurrence. Radiofrequency catheter ablation achieved an overall acute success rate of 81% in patients with congenital heart disease, though tachycardia recurrence occurred in 54% over 7.4 years of follow-up.
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