Key result
Remote magnetic navigation ablation maintains sinus rhythm at 11 months in complex post-Mustard d-TGA.
Why the study?
Catheter ablation of atrial tachycardia in patients with d-transposition of the great arteries post-Mustard correction and mechanical tricuspid valve is challenging and requires specialized approaches.
Case Report (n=1)
No
Describes the use of remote magnetic navigation for catheter ablation of atrial tachycardia in a complex adult congenital heart disease patient with a mechanical tricuspid valve.
May support feasibility of remote magnetic navigation ablation in d-TGA with mechanical valve; leaves open generalizability pending larger studies.
A 36-year-old male, who underwent Mustard correction for d-transposition of the great arteries (d TGA) at the age of 1 and received a mechanical valve in the tricuspid position (St Jude Medical 31 mm) at 25 due to valve insufficiency, was admitted to our center for catheter ablation of paroxysmal atrial tachycardia.While he remained stable until age 35, he experienced recurrent symptomatic arrhythmias resistant to pharmacotherapy.Echocardiography revealed post-Mustard correction anatomy without additional abnormalities.Three-dimensional CT displayed a mechanical valve in the tricuspid position, oriented perpendicularly to the sternum (Figure 1A).
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Orczykowski et al. (2024) conducted a case report in Atrial tachycardia (n=1). Remote magnetic navigation catheter ablation was evaluated on Restoration of sinus rhythm and freedom from arrhythmia recurrence. Remote magnetic navigation catheter ablation successfully restored sinus rhythm and prevented arrhythmia recurrence over 11 months in a patient with d-TGA, Mustard correction, and a mechanical valve.
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