Catheter ablation for atrial fibrillation in Patients after atrial Septal Defect repair

  • O. S. Stychynskyi National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
  • P. O. Almiz National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
  • N. S. Jaschuk National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
  • N. V. Melnik National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
  • A. V. Topchii National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
  • A. V. Pokanevych National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
  • O. А. Lozovoyi National Amosov Institute of Cardiovascular Surgery, Kyiv, Ukraine
DOI: https://doi.org/10.30702/ujcvs/19.36/12(063-066)
Keywords: atrial fibrillation, catheter ablation, pulmonary veins isolation, congenital heart disease, atrial septal defect

Abstract

Atrial septal defect (ASD) is one of the most common congenital heart disorders. This defect is characterized by the development of atrial tachyarrhythmias, e.g. intra-atrial reentry or atrial fibrillation (AF).

The objective of the study was to examine the safety and efficacy of AF ablation in patients after ASD repair. One-year procedural success was defined as freedom from recurrent AF, off antiarrhythmic drugs (complete freedom) or off/on previously failed antiarrhythmic drugs (complete/partial freedom).

In total, 3 patients after ASD repair were included (the age was 40, 42 and 50; the time from cardiac surgery to catheter ablation was 23, 16 and 40 years; 2 patients had paroxysmal AF). Pulmonary vein isolaton was performed in 3 patients, of whom 2 underwent pulmonary vein isolation alone. Twenty six randomly selected patients undergoing first AF ablation at the same time period, without prior cardiac surgery and without concomitant structural cardiac pathology, were used as control. Peculiarity of ablation in the first group was the use of transesophageal and intracardiac echocardiography during transseptal puncture. Duration of the procedure was 190–220 minutes.

Complete freedom was achieved within 14–18 months in 2 cases; complete/partial freedom was achieved in 1 case (no paroxysms of AF after antiarrythmic therapy in remote period). No complications were reported. The results were similar to those in the control group where complete freedom was observed in 20 (76.9%) and complete/partial freedom in 2 (7.7%) patients.

AF catheter ablation in patients after ASD repair is effective and safe. It may be recommended as a priority technique for this group of patients.

References

  1. Khairy P, Van Hare GF, Balaji S, Berul CI, Cecchin F, Cohen MI, et al. PACES/HRS Expert Consensus Statement on the Recognition and Management of Arrhythmias in Adult Congenital Heart Disease. Canadian Journal of Cardiology. 2014:(30);e1–e63. https://doi.org/10.1016/j.cjca.2014.09.002
  2. Hernández-Madrid A, Paul T, Abrams D, Aziz PF, Blom NA, Chen J, et al. Arrhythmias in congenital heart disease: a position paper of the European Heart Rhythm Association (EHRA), Association for European Paediatric and Congenital Cardiology (AEPC), and the European Society of Cardiology (ESC) Working Group on Grown-up Congenital heart disease, endorsed by HRS, PACES, APHRS, and SOLAECE. Europace2018:20(11);1719–53. https://doi.org/10.1093/europace/eux380
  3. Calkins H, Hindricks G, Cappato R, Kim YH, Saad EB, Aguinaga L, et al. 2017 HRS/EHRA/ECAS/APHRS/SOLAECE Expert consensus statement on catheter and surgical ablation of atrial fibrillation. Heart Rhythm. 2017:14(10);e276–e444. https://doi.org/10.1016/j.hrthm.2017.05.012
  4. Philip F, Muhammad KI, Agarwal S, Natale A, Krasuski RA. Pulmonary vein isolation for the treatment of drug-refractory atrial fibrillation in adults with congenital heart disease. Congenit. Heart Dis. 2012:7;392–9. https://doi.org/10.1111/j.1747-0803.2012.00649.x
  5. Liang JJ, Frankel DS, Parikh V, Lakkireddy D, Mohanty S, Burkhardt JD, et al. Safety and outcomes of catheter ablation for atrial fibrillation in adults with congenital heart disease : A multicenter registry study. Heart Rhythm. 2019:16(6);846–52. https://doi.org/10.1016/j.hrthm.2018.12.024
  6. Sohns C, Nьrnberg JH, Hebe J, Duckeck W, Ventura R, Konietschke F, et al. Catheter ablation for atrial fibrillation in adults with congenital heart disease. J.Am.Coll.Cardiol. Clinical electrophysiology. 2018;4:733–43. https://doi.org/10.1016/j.jacep.2018.01.015
  7. Guarguagli S, Kempny A, Cazzoli I, Barracano R, Gatzoulis MA, Dimopoulos K, Ernst S. Efficacy of catheter ablation for atrial fibrillation in patients with congenital heart disease. Europace. 2019;21(9):1334–44. https://doi.org/10.1093/europace/euz157
  8. Arkles J, Zado E, Supple G, Frankel DS, Callans D, Marchlinski F, Dixit S. Feasibility of transseptal access in patients with previously scarred or repaired interatrial septum. J Cardiovasc Electrophysiol. 2015 Sep;26(9):963–8. https://doi.org/10.1111/jce.12730
Published
2019-09-16
How to Cite
1.
Stychynskyi OS, Almiz PO, Jaschuk NS, Melnik NV, Topchii AV, Pokanevych AV, LozovoyiOА. Catheter ablation for atrial fibrillation in Patients after atrial Septal Defect repair. ujcvs [Internet]. 2019Jul.12 [cited 2024Dec.22];(3 (36):63-6. Available from: http://cvs.org.ua/index.php/ujcvs/article/view/303
Issue
Ukrainian Journal of Cardiovascular Surgery No 3 (36) 2019
Section
HEART RHYTHM DISORDER

Most read articles by the same author(s)