31-3-2014 1 AblativeManagement of AtrialTachycardias in AdultswithCongenitalHeartDisease Natasja MS de Groot, MD, PhD Department of Cardiology Unit Translational Electrophysiology Erasmus Medical Center, Rotterdam high incidence of atrial tachycardias in patients with surgically corrected congenital heart disease risk of atrial tachycardias associated with complexity of congenital heart disease number of surgical procedures longer time after cardiac surgery clinical problem: improved life expectancy Atrial TachyArrhythmiasin Patients with Congenital Heart Disease
31
Embed
AblativeManagement of AtrialTachycardias in ... · anti-arrhythmic drugs anti-tachycardia pacing catheter ablation Treatment of Post-Operative Atrial TachyArrhythmias possible curative
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
31-3-2014
1
Ablative Management of
Atrial Tachycardias
in Adults with Congenital Heart Disease
Natasja MS de Groot, MD, PhD
Department of Cardiology
Unit Translational Electrophysiology
Erasmus Medical Center, Rotterdam
� high incidence of atrial tachycardias in patients with
surgically corrected congenital heart disease
� risk of atrial tachycardias associated with
complexity of congenital heart disease
number of surgical procedures
longer time after cardiac surgery
� clinical problem: improved life expectancy
Atrial TachyArrhythmias in Patients withCongenital Heart Disease
31-3-2014
2
�anti-arrhythmic drugs
�anti-tachycardia pacing
�catheter ablation
Treatment of Post-Operative
Atrial TachyArrhythmias
✓ possible curative treatment option
✓ localization of the arrhythmogenic substrate: difficult
- distortion of atrial anatomy
- extensive mapping prior to ablation: essential
✓ recurrences of AT after ablation
Ablative Therapy
31-3-2014
3
What is the Mechanism ?
-macro-reentry circuit
-focal activity
Post-Operative AT
- atrial flutter cavo-tricuspid isthmus dependent
- intra-atrial reentrant tachycardiasreentrant circuit around areas of scar tissue anatomical structuressurgically created barriers