Interv Akut Kardiol. 2013;12(3):124-129

Catheter ablation in treating arrhythmias in patients with congenital heart defect

Petr Peichl, Josef Kautzner

Klinika kardiologie, IKEM, Praha

Arrhythmias are the leading cause of morbidity and mortality in adult patients with congenital heart defect. Patients in this group typically

develop incisional tachycardias. They are caused by reentry circulating around scar tissue or prosthetic material following a surgical

procedure. Most commonly, intra-atrial reentry occurs, in which the impulse circulates around a right atriotomy scar. In the case of complex

heart defects, the location of the reentry circuit is individual and, given an abnormal diversion of blood flow, catheter access to the

heart chambers may be difficult. The other types of arrhythmias, such as focal tachycardias, accessory pathway-mediated arrhythmias or

atrial fibrillations, are encountered less frequently. Through a mechanism analogical to that in intra-atrial reentry, incisional ventricular

tachycardias can occur that usually arise from the edge of a ventriculotomy scar. By using three-dimensional electroanatomic mapping

systems and imaging techniques (e.g. intracardiac echocardiography), it is possible, despite the complex anatomic relations, to achieve a

high success rate of treatment in these cardiac rhythm disorders. This review deals with the pathophysiology, classification, and current

options of catheter treatment of tachyarrhythmias in patients with congenital heart defect.

Keywords: catheter ablation, congenital heart defect, intra-atrial reentry, incisional arrhythmia, atrial tachycardia, ventricular tachycardia

Published: May 15, 2013  Show citation