Catheter Ablation of Cardiac Arrhythmias in Congenital Heart Disease

Background: Congenital heart disease (CHD) is the most common anomaly of the birth defects with an incidence rate of 8 cases per 1000 live births. As more progression in the surgery of congenital heart disease occurs, the number of patients with CHD is growing. Dierent types of tachyarrhythmias are the consequences of congenital defects (repaired or unrepaired). At birth, these arrhythmias are rarely seen in patients and are associated with myocardial fibrosis and hypertrophy. Objectives: In the present retrospective cross-sectional study, we investigate the prevalence of dierent forms of tachyarrhythmia in CHD patients and acute success rate of catheter ablation in these patients. PatientsandMethods: In this cross-sectional study 196 patients were enrolled. The data were derived from ablation sheets available at the EP center of our tertiary care center between 2001 and 2014. The age, gender, type of CHD, arrhythmia diagnosis and acute success rate of the procedure, as study variables, were all obtained through the patient's records. Results: About 196 CHD patients (mean age: 28.35 16.07; 56 males) with a complete data sheet were enrolled in the study. The most diagnostic type of CHD in these patients was Epstein anomaly with 53 cases (27.04%), the others were: Atrial septal defect (ASD) (repaired or un repaired) with 48 cases (24.49%), total correction of tetralogy of Fallot 20 (24.17%), ventricular septal defect (VSD) 18 (9.18%) and complex congenital heart disease 50 (25.38%). Out of 50 complex diagnosed CHD, the highest incidence rate was associated with fontan procedure in seven patients (14%), followed by AVSD (12%). Congenital heart disease classification of congenital heart disease severity was done according to 32nd Bethesda conference, and 16 patients (8.16%) were in the mild group of congenital heart defects, 143 (72.96%) were in the moderate group and 37 (18.88%) in the complex congenital heart defects. Our patients had dierent types of arrhythmias or conduction disorders; the most common form was accessory pathway with forms of wolf parkinson white (WPW), atrioventricular reentrant tachycardia (AVRT), mahaim and permanent junctional reciprocating tachycardia (PJRT). The second one was typical AFL while focal atrial tachycardia (AT) had the third rank. The acute success rate of catheter ablation in our patients was 89.8%. Conclusions: Radiofrequency ablation in patients with congenital heart disease and arrhythmias is both safe and eective in a short period of time and may be the preferred approach to treatment in some patients.