Congenital heart diseaseCohort study
Long-Term Efficacy of Catheter Ablation for Reentrant Atrial Tachycardia in Dextro-Transposition of the Great Arteries Patients After Atrial Switch
- Single-center ambispective cohort
- consecutive adults
Authors' conclusion
In dextro-transposition of the great arteries postatrial switch, cavotricuspid isthmus-dependent flutter is most common, but scar-related circuits are frequent. Catheter ablation is safe and acutely effective, but long-term recurrence remains substantial. Failed acute efficacy, severely impaired systemic right ventricle contractility, prolonged PR interval, and multiple inducible ATs identify patients at highest risk and may guide follow-up and referral for early repeat ablation.
Study context
- Population
- Adults with dextro-transposition of the great arteries after atrial switch undergoing a first AT ablation (2003–2025)patients, 46 procedures
- Participants
- Thirty-three adults
Main finding
As reported in the abstract
Atrial tachycardias (ATs) induced
66
characterized
51 (83%)
cavotricuspid isthmus-dependent (of characterized)
32 (63%)
incisional (of characterized)
11 (22%)
Observational data: associations, not effects.
Further findings
Acute efficacy
- Cavotricuspid isthmus block achieved
- 84%
- Acute noninducibility
- 73%
AT recurrence · Median follow-up 7.0 years (interquartile range, 2.5-10.4)
- Patients recurred
- 15 patients (45.5%)
- 1-year freedom
- 75%
Predictors of recurrence
- Associated with failed or uncertain acute efficacy, severely impaired systemic right ventricular fractional shortening ≤22%, prolonged PR interval (220 ms), and greater number of inducible ATs
- all P <0.05
- Multivariable model of 4 variables, optimism-corrected C-index
- 0.85
Redo ablation
- Underwent redo ablation
- Eleven (33%)
- Achieved acute noninducibility (of redo)
- 8
- Recurred thereafter (of redo)
- 3
Original publication
Summarised from the published abstract; every number is checked against it