Acute and long-term outcome after catheter ablation of supraventricular tachycardia in patients after the Mustard or Senning operation for D-transposition of the great arteries
Abstract
AIMS: Data about the acute and long-term outcome of catheter ablation in patients with D-transposition of the great arteries (d-TGA) post-Mustard/Senning operation are scarce. METHODS AND RESULTS: This single-centre retrospective analysis includes 26 patients (mean age 28.7 ± 6.7 years, 8 females) after Mustard (n = 15) or Senning (n = 11) operation who underwent catheter ablation for intra-atrial re-entrant tachycardia (IART) or atrioventricular nodal re-entrant tachycardia (AVNRT) from January 2004 to May 2011. The electrophysiological studies were performed using a three-dimensional mapping system (CARTO). Remote magnetic navigation (RMN) was available since 2008. Follow-up on an outpatient basis was conducted 3, 6, and 12 months after ablation and yearly thereafter. In the 26 patients, 34 procedures were performed (one procedure n = 19, two n = 6, and three n = 1). Overall, 34 tachycardia forms (IART n = 30; AVNRT n = 4) were ablated manually (n = 25) or by RMN (n = 9). Acute success reached in 29/34 forms (85.3%). Mean fluoroscopy time (FT) was 28.2 ± 20.7 min and mean procedure duration (PD) was 290.9 ± 107.6 min. After a mean follow-up of 34.1 ± 24.5 months, 25/26 (96.2%) patients were free from IART or AVNRT. In the nine RMN ablations (mean follow-up 14.2 ± 5.8 months) acute and long-term success was 100%. Fluoroscopy time and PD were significantly reduced using RMN compared with manual ablation (11.9 ± 6.2 vs. 34.6 ± 20.6 min, 225.7 ± 24.1 vs. 312 ± 118.2 min, P = 0.02). CONCLUSION: Catheter ablation of IART or AVNRT in patients post-Mustard/Senning operation for d-TGA has a high acute success rate. The recurrence rate for IART is about 30%; however, after a second ablation, long-term results are excellent. Remote magnetic navigation seems to improve single-procedure acute and long-term success and significantly reduces FT and PD.
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The acute success rates of catheter ablation procedures of SVT in ACHD patients range from 65 to 100%, with a higher recurrence rate, 20-60% within 2 years, than seen in other cohorts for routine SVT ablation.
“The acute success rates of catheter ablation procedures of SVT in ACHD patients ranges from 65 to 100%, with a higher recurrence rate, 20 -60% within 2 years, than seen in other cohorts for routine SVT ablation.362 -364,379”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [364]
Catheter ablation of IART and AVNRT in patients following Mustard or Senning operation for d-TGA has a high primary success rate albeit high 30% recurrence rates for IART but excellent long-term results after a second ablation.
“Catheter ablation of IART and AVNRT in patients following Mustard or Senning operation for d-TGA has a high primary success rate albeit high 30% recurrence rates for IART but excellent longterm results after a second ablation.364”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [364]
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- Authors
- Wu, J., Deisenhofer, I., Ammar, S., Fichtner, S., Reents, T., Zhu, P., Jilek, C., Kolb, C., Hess, J., & Hessling, G.
- Affiliations
- Shanghai Children's Medical Center (CN)
- Deutsches Herzzentrum München (DE)
- Corresponding author
- Wu, Jinjin
- Venue
- EP Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2013-01-25
- Volume
- 15
- Issue
- 6
- Pages
- 886-891
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2153550932
- Cited by
- 78
- References
- 16
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 2 · 2023: 6 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 3 · 2018: 7 · 2017: 11 · 2016: 11 · 2015: 6 · 2014: 4 · 2013: 3
- FWCI
- 5.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- supraventricular tachycardia, d-transposition of the great arteries, Mustard operation, Senning procedure, catheter ablation, atrioventricular nodal reentrant tachycardia, remote magnetic navigation, fluoroscopy time, long-term outcomes, congenital heart disease, 3D electroanatomical mapping
- MeSH terms
- Adult, Female, Humans, Longitudinal Studies, Male, Myocardial Revascularization, Reoperation, Tachycardia, Supraventricular, Transposition of Great Vessels, Treatment Outcome, Catheter Ablation, Plastic Surgery Procedures
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