Advanced search
Add to list

Long-term outcome of ablative therapy of post-operative atrial tachyarrhythmias in patients with tetralogy of Fallot: a European multi-centre study

(2012) EUROPACE. 14(4). p.522-527
Author
Organization
Abstract
Post-operative atrial tachyarrhythmias (AT) in patients with tetralogy of Fallot (ToF) are associated with congestive heart failure, stroke, and cardiac death. Effective treatment is therefore essential. The aim of the study is to evaluate long-term outcome of ablative therapy of AT in ToF patients and to study characteristics of AT recurrences. Tetralogy of Fallot patients (N 38, age 43 12 years) referred for ablation of post-operative AT, appearing 26 10 years after complete repair, were studied. Electro-anatomical/entrainment mapping was performed prior to ablation. Successful ablation was defined as (i) achievement of bi-directional conduction block for isthmus-dependent atrial flutter (IDAF), (ii) termination during ablation for intra-atrial reentrant tachycardia (IART) and focal atrial tachycardia (FAT). Fifty-two AT were ablated, including 37 IDAF [cycle length (CL) 294 70 ms], 11 IART (CL 295 46 ms), and 4 FAT (CL 371 93 ms). Ablation was successful in 98. Fifty-one of 52 AT involved the cavo-tricuspid isthmus and/or the area between scar tissue related to prior atriotomy incisions and the inferior caval vein. Multiple AT developed in 11 patients, with different mechanisms in 9. After 45 24 months, 32 patients were in sinus rhythm; 5 used anti-arrhythmic drugs. Ablative therapy of AT in ToF patients is an effective curative treatment modality with a high procedural success rate. Sinus rhythm during long-term follow-up was obtained in the majority of patients. Fifty-one of 52 AT originated from sites related to surgical incisions created at complete repair, suggesting that extending the atriotomy incision towards the inferior caval vein during cardiac surgery combined with surgical ablation of the cavo-tricuspid isthmus will be effective in preventing development of AT.
Keywords
Tetralogy of Fallot, Atrial tachyarrhythmias, Mapping, Ablative therapy, CONGENITAL HEART-DISEASE, INTRAATRIAL REENTRANT TACHYCARDIA, RADIOFREQUENCY ABLATION, REPAIR, ADULTS, ARRHYTHMIAS, SURGERY, SUBSTRATE, CIRCUITS, DEFECTS

Citation

Please use this url to cite or link to this publication:

MLA
de Groot, Natasja MS, et al. “Long-Term Outcome of Ablative Therapy of Post-Operative Atrial Tachyarrhythmias in Patients with Tetralogy of Fallot: A European Multi-Centre Study.” EUROPACE, vol. 14, no. 4, 2012, pp. 522–27, doi:10.1093/europace/eur313.
APA
de Groot, N. M., Lukac, P., Schalij, M. J., Makowski, K., Szili-Torok, T., Jordaens, L., … Delacretaz, E. (2012). Long-term outcome of ablative therapy of post-operative atrial tachyarrhythmias in patients with tetralogy of Fallot: a European multi-centre study. EUROPACE, 14(4), 522–527. https://doi.org/10.1093/europace/eur313
Chicago author-date
Groot, Natasja MS de, Peter Lukac, Martin J Schalij, Karol Makowski, Tamas Szili-Torok, Luc Jordaens, Jens Consedis Nielsen, Henrik Kjærulf Jensen, Jens Christian Gerdes, and Etienne Delacretaz. 2012. “Long-Term Outcome of Ablative Therapy of Post-Operative Atrial Tachyarrhythmias in Patients with Tetralogy of Fallot: A European Multi-Centre Study.” EUROPACE 14 (4): 522–27. https://doi.org/10.1093/europace/eur313.
Chicago author-date (all authors)
de Groot, Natasja MS, Peter Lukac, Martin J Schalij, Karol Makowski, Tamas Szili-Torok, Luc Jordaens, Jens Consedis Nielsen, Henrik Kjærulf Jensen, Jens Christian Gerdes, and Etienne Delacretaz. 2012. “Long-Term Outcome of Ablative Therapy of Post-Operative Atrial Tachyarrhythmias in Patients with Tetralogy of Fallot: A European Multi-Centre Study.” EUROPACE 14 (4): 522–527. doi:10.1093/europace/eur313.
Vancouver
1.
de Groot NM, Lukac P, Schalij MJ, Makowski K, Szili-Torok T, Jordaens L, et al. Long-term outcome of ablative therapy of post-operative atrial tachyarrhythmias in patients with tetralogy of Fallot: a European multi-centre study. EUROPACE. 2012;14(4):522–7.
IEEE
[1]
N. M. de Groot et al., “Long-term outcome of ablative therapy of post-operative atrial tachyarrhythmias in patients with tetralogy of Fallot: a European multi-centre study,” EUROPACE, vol. 14, no. 4, pp. 522–527, 2012.
@article{8135622,
  abstract     = {{Post-operative atrial tachyarrhythmias (AT) in patients with tetralogy of Fallot (ToF) are associated with congestive heart failure, stroke, and cardiac death. Effective treatment is therefore essential. The aim of the study is to evaluate long-term outcome of ablative therapy of AT in ToF patients and to study characteristics of AT recurrences. 
Tetralogy of Fallot patients (N 38, age 43 12 years) referred for ablation of post-operative AT, appearing 26 10 years after complete repair, were studied. Electro-anatomical/entrainment mapping was performed prior to ablation. Successful ablation was defined as (i) achievement of bi-directional conduction block for isthmus-dependent atrial flutter (IDAF), (ii) termination during ablation for intra-atrial reentrant tachycardia (IART) and focal atrial tachycardia (FAT). Fifty-two AT were ablated, including 37 IDAF [cycle length (CL) 294 70 ms], 11 IART (CL 295 46 ms), and 4 FAT (CL 371 93 ms). Ablation was successful in 98. Fifty-one of 52 AT involved the cavo-tricuspid isthmus and/or the area between scar tissue related to prior atriotomy incisions and the inferior caval vein. Multiple AT developed in 11 patients, with different mechanisms in 9. After 45 24 months, 32 patients were in sinus rhythm; 5 used anti-arrhythmic drugs. 
Ablative therapy of AT in ToF patients is an effective curative treatment modality with a high procedural success rate. Sinus rhythm during long-term follow-up was obtained in the majority of patients. Fifty-one of 52 AT originated from sites related to surgical incisions created at complete repair, suggesting that extending the atriotomy incision towards the inferior caval vein during cardiac surgery combined with surgical ablation of the cavo-tricuspid isthmus will be effective in preventing development of AT.}},
  author       = {{de Groot, Natasja MS and Lukac, Peter and Schalij, Martin J and Makowski, Karol and Szili-Torok, Tamas and Jordaens, Luc and Nielsen, Jens Consedis and Jensen, Henrik Kjærulf and Gerdes, Jens Christian and Delacretaz, Etienne}},
  issn         = {{1099-5129}},
  journal      = {{EUROPACE}},
  keywords     = {{Tetralogy of Fallot,Atrial tachyarrhythmias,Mapping,Ablative therapy,CONGENITAL HEART-DISEASE,INTRAATRIAL REENTRANT TACHYCARDIA,RADIOFREQUENCY ABLATION,REPAIR,ADULTS,ARRHYTHMIAS,SURGERY,SUBSTRATE,CIRCUITS,DEFECTS}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{522--527}},
  title        = {{Long-term outcome of ablative therapy of post-operative atrial tachyarrhythmias in patients with tetralogy of Fallot: a European multi-centre study}},
  url          = {{http://doi.org/10.1093/europace/eur313}},
  volume       = {{14}},
  year         = {{2012}},
}

Altmetric
View in Altmetric
Web of Science
Times cited: