Very long-term results of electroanatomic-guided radiofrequency ablation of atrial arrhythmias in patients with surgically corrected atrial septal defect
Abstract
AIMS: Atrial tachycardias are common after repair of atrial septal defect (ASD). Although ablation has shown promising results in the short and mid-term follow-up, little data regarding the very long-term success exist. Our aim was to assess very long-term follow-up in patients who have undergone electroanatomic-guided radiofrequency (RF) ablation of late-onset atrial arrhythmias after ASD surgery. METHODS AND RESULTS: Forty-six consecutive patients with surgically repaired ASD were referred for atrial tachycardia ablation. Electrophysiological (EP) study and ablation procedure with the aid of an electroanatomic mapping (EAM) system were performed. Mean age was 49 ± 13 years (females 61%). The presenting arrhythmias were typical atrial flutter (48%), atypical atrial flutter (35%), and atrial tachycardia (17%). In 41% of patients, atrial fibrillation was also present. The EP study showed a right atrial macroreentrant circuit in all the patients. In 12 of 46 (26%), the circuit was localized in the cavo-tricuspid isthmus, whereas in the remaining 34 patients (74%) was atriotomy-dependent. Acute success was 100%. Clinical arrhythmia recurred in 24% of the patients. Nine patients underwent a second and two a third ablation procedure, reaching an overall efficacy of 87% (40 of 46) at a mean follow-up of 7.3 ± 3.8 years since the last procedure. With antiarrhythmic drugs the success rate increased to 96% (44 of 46). No complications occurred. CONCLUSION: In patients with surgically corrected ASD, EAM-guided RF ablation of late-onset macroreentrant atrial arrhythmias demonstrated a high success rate in a very long-term follow-up. Therefore, RF ablation could be considered early in the management of late-onset macroreentrant atrial tachycardias.
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Catheter ablation is associated with excellent results in patients with repaired ASD.
“Catheter ablation is associated with excellent results.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 [379]
Catheter ablation of late atrial arrhythmias has shown to be effective in 46 consecutive patients after surgical atrial septal defect.
“Catheter ablation of late atrial arrhythmias has shown to be effective in 46 consecutive patients after surgical atrial septal defect.977”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [977]
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- Authors
- Scaglione, M., Caponi, D., Ebrille, E., Di Donna, P., Di Clemente, F., Battaglia, A., Raimondo, C., Appendino, M., & Gaita, F.
- Affiliations
- Azienda Sanitaria Locale di Asti (IT)
- University of Turin (IT)
- Corresponding author
- Scaglione, Marco
- Venue
- EP Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2014-05-19
- Volume
- 16
- Issue
- 12
- Pages
- 1800-1807
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2081316841
- Cited by
- 37
- References
- 23
- Citations by year
- 2025: 4 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 5 · 2017: 4 · 2016: 6 · 2015: 8
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- Institutional Research Information System University of Turin (University of Turin) (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 › Atrial Fibrillation Management and Outcomes
- Keywords
- atrial septal defect, atrial tachycardia, atrial flutter, atrial fibrillation, electroanatomical mapping, radiofrequency ablation, cavotricuspid isthmus, antiarrhythmic drugs, arrhythmia recurrence
- MeSH terms
- Atrial Fibrillation, Atrial Flutter, Female, Heart Septal Defects, Atrial, Humans, Longitudinal Studies, Male, Middle Aged, Treatment Outcome, Catheter Ablation, Body Surface Potential Mapping, Surgery, Computer-Assisted
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