Why the study?
Atrial tachyarrhythmia has become prevalent in adults with repaired tetralogy of Fallot who are living longer, but patient characteristics and tachycardia mechanisms require identification.
What are the clinical characteristics, mechanisms, and catheter ablation outcomes of atrial tachycardia in patients with repaired tetralogy of Fallot?
What are the clinical characteristics, mechanisms, and catheter ablation outcomes of atrial tachycardia in patients with repaired tetralogy of Fallot?
In patients with repaired tetralogy of Fallot, atrial tachycardia is associated with biventricular dysfunction and bi-atrial dilatation, and catheter ablation with aggressive induction of further ATs may help reduce recurrence.
AT links to dysfunction in repaired tetralogy of Fallot; ablation recurrence data leave optimal strategies open for prospective confirmation.
Patients with repaired tetralogy of Fallot (TOF) now live longer. However, dysrhythmia becomes prevalent in adults with repaired TOF, especially atrial tachyarrhythmia. To identify the characteristics of patients who develop atrial tachycardia (AT) and the mechanism of the clinical AT and the induced one. Seventy-seven patients with repaired TOF were enrolled. The patients were divided into two groups (AT and non-AT). Clinical and electrophysiologic data were studied. The mean age was 34 years. Twenty-three patients had AT (30%). In AT group, the left ventricular ejection fraction was lower (58± 6 vs 62± 5; P =0.011), the right and left atrial area (cm 2 ) was larger (29± 13 vs 15± 5; P <0.001, and 19± 3 vs 16± 4; P <0.001, respectively), and the right ventricular S' wave (cm/s) was smaller (8± 2 vs 10± 3; P = 0.029). Patients with AT underwent catheter ablation, and 32 AT were ablated. The mechanism of AT was intra-atrial reentrant tachycardia in 14 AT (44%), cavotricuspid isthmus-dependent in 12 AT (37%), and focal activity in the remaining 6 AT (19%). An important finding was that after the first AT was ablated, another AT was induced in 7 patients. The mechanism was focal in about half of them, in contrast to the first ablated AT, where the focal mechanism was the least common. After a median follow-up of 37 months, four patients had AT recurrence. The patients with AT had biventricular dysfunction and bi-atrial dilatation. Aggressive induction and ablation of the induced AT may reduce the future AT recurrence.
No takes yet. Share an insight, caveat, or question.
Naeemah et al. (2024) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: