Catheter Ablation of Atrial Fibrillation in Adult Congenital Heart Disease: Procedural Characteristics and Outcomes
Authors' conclusion
Catheter ablation of atrial fibrillation is feasible and effective in patients with adult congenital heart disease and reduces symptoms. Recurrence of AA frequently requires repeat ablation.
Study context
- Population
- Adults with congenital heart disease undergoing catheter ablation for AF at Mayo Clinic, 2000–2020198 ablations
- Participants
- 145 adults
- Outcome
- Atrial arrhythmia (AA) recurrence after a 3-month blanking period and repeat ablation
Methodological detailssingle-centre, Median follow-up 26 months (IQR 14-69), CHD complexity: 110 simple, 26 moderate, 9 complex, All underwent pulmonary vein isolation; non-pulmonary vein targets ablated in 79 (54%)
- Single-centre
- Median follow-up 26 months (IQR 14-69)
- CHD complexity: 110 simple, 26 moderate, 9 complex
- All underwent pulmonary vein isolation; non-pulmonary vein targets ablated in 79 (54%)
Main finding
As reported in the abstract
AA recurrence · 12 months
Atrial arrhythmia (AA) recurrence at 12 months
37%
95% CI 29%–45%
Second ablation
43 patients after a median of 20 (IQR 8-37) months
Observational data: associations, not effects.
Further findings
| Outcome | OR (CI) | P value | |
|---|---|---|---|
| Predictors of AA recurrence (univariate analysis)Left atrial volume index (per 1 mL/m² increment) · univariate analysis | 1.03 (1.00–1.06) | P = 0.05 | |
| 0.512Odds ratio (log scale) |
Predictors of AA recurrence (univariate analysis)
| OR (CI) | P value | ||
|---|---|---|---|
| Noninducibility of atrial flutterUnivariate analysis | 0.43 (0.21–0.90) | P = 0.03 | |
| 0.20.5125Odds ratio (log scale) |
Arrhythmia clinical severity score
- Improved after ablation, with fewer symptoms, cardioversions and antiarrhythmic drugs
Original publication
Catheter Ablation of Atrial Fibrillation in Adult Congenital Heart Disease: Procedural Characteristics and Outcomes. Circ Arrhythm Electrophysiol. Published 24 July 2023. doi:10.
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