Arrhythmias & electrophysiologyCohort study
Empirical Cavotricuspid Isthmus Ablation in Congenital Heart Disease
- prospective nationwide study
Authors' conclusion
Empirical CTI ablation is associated with improved freedom from atrial arrhythmia and reduced rehospitalization in CHD patients.
Study context
- Population
- Congenital heart disease (CHD) patients referred for a first catheter ablation of an atrial arrhythmia between 2020 and 2024, without cavotricuspid isthmus (CTI)-dependent flutterstudy population, of 575 patients undergoing a first catheter ablation for atrial arrhythmia, 345 (60.0%) had CTI-dependent flutter and are not in the study population
- Participants
- 230 patients
- Exposure
- Empirical CTI ablation vs no empirical CTI ablation
- Empirical CTI ablationn = 71
- Outcome
- Freedom from any atrial arrhythmia recurrence
- Follow-up
- 1 year and 2 years
Main finding
As reported in the abstract
Hazard ratio
0.47
95% CI 0.24–0.92
P = 0.027
By group
Empirical CTI ablation
78.1%
1 year · 2 years 71.2%
No empirical CTI ablation
65.6%
1 year · 2 years 56.1%
Empirical CTI ablation vs No empirical CTI ablation
HR 0.47 (95% CI 0.24–0.92); P = 0.027
Observational data: associations, not effects.
Secondary outcomes
Arrhythmia-related hospitalization
- Arrhythmia-related hospitalization: P = 0.048
Study population characteristics
- mean age
- 48.2 ± 16.4 years
- male
- 50.9%
- CHD complexity moderate
- 57.4%
- atrial macro-re-entry
- 53.0%
- atrial fibrillation
- 47.0%
- focal atrial tachycardia
- 17.4%
- multiple arrhythmias
- 16.5%
Original publication
Empirical Cavotricuspid Isthmus Ablation in Congenital Heart Disease. JACC Clin Electrophysiol. Published 1 September 2026. doi:10.1016/j.jacep.2026.07.023
Summarised from the published abstract; every number is checked against it