https://scholars.lib.ntu.edu.tw/handle/123456789/538301
標題: | Radiofrequency catheter ablation of atrial tachyarrhythmias in adults with repaired congenital heart disease: Constraints from multiple and new arrhythmic foci | 作者: | SHUENN-NAN CHIU JIUNN-LEE LIN CHIA-TI TSAI CHIH-CHIEH YU CHUN-WEI LU Chang C.-W. Chang C.-C. JOU-KOU WANG MEI-HWAN WU |
公開日期: | 2013 | 卷: | 29 | 期: | 4 | 起(迄)頁: | 347-356 | 來源出版物: | Acta Cardiologica Sinica | 摘要: | Background: Radiofrequency catheter ablation (RFCA) for atrial tachyarrhythmias in postoperative congenital heart disease (CHD) patients has a low success rate and a high recurrence rate. This study explores the reasons for these constraints. Methods: A total of 49 consecutive postoperative CHD patients who received RFCA for atrial tachyarrhythmias between 1993 and 2010 were enrolled. Results: Overall, there were 86 RFCA procedures performed, 32 with the conventional method and 54 using CARTO-guided mapping. The interval between the operation and the first ablation was 13 years. Isthmusdependent atrial flutter (AFL)was the most common type of tachycardia (37, 76%), followed by intra-atrial re-entry tachycardia (IART; 37%), and ectopic atrial tachycardia (EAT; 31%). By applying CARTO-guided mapping, the success ratewas elevated compared to that of conventional ablation (84% vs. 56%, p = 0.006), but therewas no improvement in the recurrence rate (22% vs. 28%, p = 0.75).Multiple atrial tachyarrhythmias occurred in 26 (53%) patients, and 17 presented during the initial electrophysiological study. The presence of multiple arrhythmias during the initial study predicted ablation failure or multiple ablations (11/17 vs. 3/32, p < 0.001). Among the 15 patients with new tachyarrhythmias, EAT and IART predominated. However, applying antiarrhythmia agents immediately following ablation may decrease arrhythmia recurrence (1/10 vs. 14/25, p = 0.02). Conclusions: Although electroanatomical mapping improves the results of RFCA in atrial tachyarrhythmias, the recurrence rate remains high because of multiple and new atrial tachyarrhythmias. Therefore, short-term pharmacological treatment following RFCA for positive remodeling should be considered. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84880599694&partnerID=40&md5=bd6b316b8e0216188e4a97bbd53e5717 https://scholars.lib.ntu.edu.tw/handle/123456789/538301 |
ISSN: | 1011-6842 | SDG/關鍵字: | adolescent; adult; aged; article; catheter ablation; child; clinical article; congenital heart disease; controlled study; ectopic atrial tachycardia; electrophysiology; female; heart atrium arrhythmia; heart atrium flutter; heart surgery; human; infant; intermethod comparison; intra atrial re entry tachycardia; male; multiple atrial tachyarrhythmias; outcome assessment; postoperative care; preschool child; recurrence risk; school child; treatment failure; treatment outcome |
顯示於: | 醫學系 |
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