|Condition||Recommendation||Classification||Level of Evidence||References|
|Failed antiarrhythmic drugs and symptomatic:|
|•Repaired ASD||Catheter ablation in an experienced center||I||C||172,174,175,178,181,210,224,225|
|•Mustard or Senning repair of transposition of the great vessels||Catheter ablation in an experienced center||I||C||175,178,181,210|
|Unrepaired asymptomatic ASD not hemodynamically significant||Closure of the ASD for treatment of the arrhythmia||III||C||208,209|
|Unrepaired hemodynamically significant ASD with atrial flutter∗||Closure of the ASD combined with ablation of the flutter isthmus||I||C|
|PSVT and Ebstein’s anomaly with hemodynamic indications for surgical repair||Surgical ablation of accessory pathways at the time of operative repair of the malformation at an experienced center||I||C||220,226|
ASD indicates atrial septal defect; PSVT, paroxysmal supraventricular tachycardia.
↵∗ Conversion and antiarrhythmic drug therapy initial management as described for atrial flutter (see Section V-F).