Key result
Catheter ablation of intra-atrial reentrant tachycardias achieved a 66% success rate over 105 months, with significant differences between giant and non-giant right atrium groups (P<0.01).
Why the study?
Does linear catheter ablation guided by pace-map and entrainment mapping improve long-term success of intra-atrial reentrant tachycardias in patients with prior repair of congenital heart disease?
Cohort (n=106)
Does linear catheter ablation guided by pace-map and entrainment mapping improve long-term success of intra-atrial reentrant tachycardias in patients with prior repair of congenital heart disease?
Entrainment mapping and pace-mapping combined with 3D electroanatomic mapping is an effective strategy for identifying critical isthmuses and achieving successful linear ablation of IARTs in patients with prior congenital heart disease repair.
Supports mapping-guided ablation for post-repair IARTs; leaves open randomized confirmation of long-term efficacy and giant atrium subgroups.
Introduction: The aim of this study was to develop bidirectional block of intra-atrial reentrant tachycardias (IARTs) late after the repair of congenital heart disease (CHD) using pace-map and entrainment mapping.Methods and results: There were 106 patients enrolled in this study. These patients were divided into two groups as giant right atrium (RA) group and non-giant RA group based on their RA volume measured by Carto. All patients have performed activation and entrainment mapping among these patients, 24 (22.6%) of Giant RA group had dual-loop reentry and 82 patients had single loop reentry. 94 patients (88.7%) found out the gaps by pace-map in SR. Linear ablation was successful in 105 patients (99%). During a mean follow-up period of 105 ± 34 months the success rate of IARTs was 66%, there were significantly different in these two groups(P<0.01). Seven (6.6%) patients in Giant RA group undergone redo procedure.Conclusion: Entrainment mapping in tachycardia and pace-map combined with three-dimensional electroanatomic mapping can elaborate the mechanism of complex re-entry circuits and critical isthmuses as targets for ablation. Pace-map in SR may be a good method for seeking the gap of ablation line to be bidirectional block for linear ablation IARTs.
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Luo et al. (2018) conducted a cohort in Intra-atrial reentrant tachycardias (IARTs) after repair of congenital heart disease (n=106). Catheter ablation using pace-map and entrainment mapping vs. Non-giant right atrium (RA) group was evaluated on Long-term success rate of IARTs ablation (p=<0.01). Catheter ablation of intra-atrial reentrant tachycardias achieved a 66% success rate over 105 months, with significant differences between giant and non-giant right atrium groups (P<0.01).
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