Arrhythmias & electrophysiologyResearch article
Arrhythmias in d-transposition of the great arteries after Mustard- or Senning-type atrial redirection surgery: 22 years of experience in catheter ablation and follow-up
- retrospectively analyzed
- tertiary referral center
- June 2001 and June 2023
Authors' conclusion
Catheter ablation in patients with d-TGA with M/S surgery is feasible and highly effective, with durable results for targeted arrhythmias. However, the high incidence of de novo arrhythmias underscores the persistent risk for arrhythmias in this population and highlights the need for adjusted long-term management strategies.
Study context
- Population
- Patients with d-TGA after Mustard or Senning (M/S) atrial redirection surgery who underwent electrophysiologic procedures for atrial tachyarrhythmiapatients, 160 electrophysiological procedures · Mustard 50
- Participants
- 97 patients
- Comparison
- Arrhythmias during follow-up after Mustard than Senning surgery
- Mustardn = 50
Main finding
As reported in the abstract
Total tachyarrhythmias identified
111
Further findings
| Outcome | hazard ratio (95% CI) | P value | |
|---|---|---|---|
| Arrhythmias during follow-up · more common after Mustard | 1.87 (1.06–3.31) | P = 0.030 | |
| 0.20.5125Hazard ratio (log scale) |
Cavotricuspid isthmus (CTI)-dependent macro-reentrant atrial tachycardia
- Most common substrate; successfully treated in procedures
- 90%
Localized reentrant atrial tachycardia
- Second most frequent arrhythmia with an age-dependent increase in relative frequency
Acute success of substrate-guided ablations
- Substrate-guided ablations acutely successful
- 86%
Tachyarrhythmias during follow-up · median follow-up of 6.0 years
- Tachyarrhythmias occurred
- 95
- Recurrences of previously ablated arrhythmias
- 13%
Subsequent arrhythmias, strategic CTI ablation vs substrate-guided ablations
- Not associated with a statistically significant increase
Original publication
Summarised from the published abstract; every number is checked against it