Author + information
- Received December 3, 2009
- Revision received March 12, 2010
- Accepted April 6, 2010
- Published online November 2, 2010.
- Sing-Chien Yap, MD, PhD⁎,‡,
- Louise Harris, MB, ChB⁎,
- Candice K. Silversides, MD⁎,
- Eugene Downar, MD† and
- Vijay S. Chauhan, MD†,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Vijay S. Chauhan, Division of Cardiology, Toronto General Hospital, University Health Network, 150 Gerrard Street West, Toronto, Ontario M5G 2C4, Canada
Objectives The aim of this study was to determine the acute and long-term outcome of radiofrequency catheter ablation (RFCA) for intra-atrial re-entrant tachycardia (IART) in adults with congenital heart disease (CHD), and predictors of these outcomes.
Background Atrial myopathy can be progressive in CHD and contributes to the substrate for IART. Although the outcome of RFCA for IART has been well described in children and adolescents with CHD, it is unclear whether these results are similar in the adult population.
Methods Clinical records of adults with CHD undergoing attempted RFCA of IART were analyzed retrospectively. Multivariate analyses identified clinical and procedural factors that predicted acute and long-term outcomes.
Results A total of 193 procedures was performed in 130 patients (mean age 40 ± 13 years); 82 of 118 (69%) initially attempted RFCA were successful, defined as termination of all IART circuits. The use of electroanatomic mapping was associated with a successful RFCA, whereas Fontan palliation and Mustard repair were associated with an unsuccessful RFCA. Median clinical follow-up of 77 patients (≥2 months of follow-up) after a successful RFCA was 3.7 years (range 0.2 to 10.2 years). IART recurrence was noted in 48%, cardioversion/reablation in 42%, and death in 4%. Older age and Fontan palliation were independent predictors of IART recurrence.
Conclusions In adults with CHD, acute and long-term outcomes of RFCA for IART are similar to those reported for younger cohorts. Complex atrial surgery limits the success of RFCA, and older age is associated with a higher risk of IART recurrence.
The authors have reported that they have no relationships to disclose.
- Received December 3, 2009.
- Revision received March 12, 2010.
- Accepted April 6, 2010.
- American College of Cardiology Foundation