| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 2001;103:2266.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Atrial Reentrant Tachycardia After Surgery for Congenital Heart Disease
Endocardial Mapping and Radiofrequency Catheter Ablation Using a Novel, Noncontact Mapping System
From the Department of Pediatric Cardiology and Pediatric Intensive Care Medicine (T.P., B.W.-M., T. Kriebel, H.B., R.K.) and the Department of Cardiology and Angiology (T. Korte, M.N., J.T.), Hannover Medical School, Hannover, Germany.
Correspondence to Thomas Paul, MD, Dept of Pediatric Cardiology and Pediatric Intensive Care Medicine, Hannover Medical School, D-30623 Hannover, Germany. E-mail Paul.Thomas{at}MH-Hannover.De
Background—The purpose of the present study was to determine the role of a novel, noncontact mapping system for assessing a variety of atrial reentrant tachycardias (ART) in patients after the surgical correction of congenital heart disease.
Methods and Results—In 14 patients, an electrophysiological study using the Ensite 3000 system was performed to assess ARTs resistant to medical treatment. Sixteen different forms of ART were inducible in the 14 patients studied. The reentrant circuit of all ARTs could be characterized and localized with respect to anatomic landmarks such as atriotomy scars, intraatrial patches/baffles, and cardiac structures. In 15 of the 16 ARTs (in 13 of the 14 patients), a target area of the reentrant circuit for radiofrequency current application (ie, an area of conduction between 2 anatomical obstacles such as surgical barriers and cardiac structures of electrical isolation) could be localized within the systemic venous atrium. Nine patients exhibited macroreentry, and 4 showed microreentry. In 12 patients, ART could be terminated by creating linear radiofrequency current lesions (75°C, 180 to 390 s). Completeness of linear lesions after radiofrequency current delivery was proven by analyzing color-coded isopotential maps of atrial activation while applying atrial pacing techniques. The mean duration of the procedures was 286 minutes (range, 130 to 435 minutes); fluoroscopy time ranged from 7 to 33.8 minutes (mean, 17.4 minutes).
Conclusions—In patients with ART after the surgical correction of congenital heart disease, the use of the noncontact mapping system allows for characterization of the tachycardia and guidance for effective radiofrequency current delivery.
Key Words: tachycardia • heart defects, congenital • mapping • catheter ablation
This article has been cited by other articles:
 |
|
 |
|
  P. Peichl, J. Kautzner, and R. Gebauer Ablation of atrial tachycardias after correction of complex congenital heart diseases: utility of intracardiac echocardiography Europace, January 1, 2009; 11(1): 48 - 53. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Liew, A. Catanchin, E. R. Behr, and D. Ward Use of non-contact mapping in the treatment of right atrial tachycardias in patients with and without congenital heart disease Europace, August 1, 2008; 10(8): 972 - 981. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. J. Kanter The Fontan Right Atrium--In Context Circulation, April 3, 2007; 115(13): 1698 - 1700. [Full Text] [PDF]
|
|
|
|
 |
|
 C.-T. Tai, T.-Y. Liu, P.-C. Lee, Y.-J. Lin, M.-S. Chang, and S.-A. Chen Non-contact mapping to guide radiofrequency ablation of atypical right atrial flutter J. Am. Coll. Cardiol., September 1, 2004; 44(5): 1080 - 1086. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Vignati, G. Crupi, V. Vanini, F. S. Iorio, A. Borghi, and S. Giusti Surgical treatment of arrhythmias related to congenital heart diseases Ann. Thorac. Surg., April 1, 2003; 75(4): 1194 - 1199. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Anne, H. van Rensburg, J. Adams, H. Ector, F. Van de Werf, and H. Heidbuchel Ablation of post-surgical intra-atrial reentrant tachycardia. Predilection target sites and mapping approach Eur. Heart J., October 2, 2002; 23(20): 1609 - 1616. [Abstract] [Full Text] [PDF]
|
|