Mechanism and ablation of arrhythmia following total cavopulmonary connection
Open accessAbstract
BACKGROUND: The ability to identify and ablate different arrhythmia mechanisms after the total cavopulmonary connection has not been studied in detail. METHODS AND RESULTS: After obtaining Institutional Review Board approval according to institutional guidelines, consecutive patients after a total cavopulmonary connection undergoing electrophysiology study over a 6-year period were included (2006-2012). Arrhythmia mechanism was determined, and the procedural outcome was defined as complete, partial success, or failure. A 12-point arrhythmia severity score was calculated for each patient at baseline and on follow-up. Fifty-seven procedures were performed on 52 patients (18.4 ± 11.8 years; 53.0 ± 27.2 kg). Access to the pulmonary venous atrium was necessary in 33 procedures, via fenestration (16) or transbaffle puncture (17), and in 2 cases, an additional retrograde approach was used. In total, 80 arrhythmias were identified in 47 cases: macroreentrant (n = 25) or focal atrial tachycardia (n = 8), atrioventricular nodal reentry tachycardia (n = 13), reentry via an accessory pathway (n = 4) or via twin atrioventricular nodes (n = 4), ventricular tachycardia (n = 5), and undefined atrial tachycardia (n = 21). Procedural outcome in 32 patients who underwent ablation was complete success (n = 25), partial success (n = 3), failure (n = 3), or empirical ablation (n = 1). After successful ablation, there was a significant decrease in arrhythmia score over 18.2 (4-32) months follow-up, with a sustained trend even in the face of arrhythmia recurrence (50%). CONCLUSIONS: Arrhythmia mechanism post total cavopulmonary connection is highly varied, encompassing simple and more complex substrates, documentation of which facilitates a strategic approach to invasive arrhythmia management. Despite the anatomic limitations, successful and clinically meaningful ablation is possible.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Catheter ablation of atrial arrhythmia in Fontan patients has been successful in selected patients.
“Catheter ablation of atrial arrhythmia in Fontan patients has been successful in selected patients.986”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [986]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Surgical repair of tricuspid atresia
Fontan, F. M., & Baudet, E. (1971) · Thorax · doi:10.1136/thx.26.3.240 · Cited by 2,900 · see citing works
de Leval, M. R., Kilner, P. J., Gewillig, M. H. M. L., & Bull, C. (1988) · PubMed · Cited by 1,028 · see citing works
de Leval, M. R., Kilner, P. J., Gewillig, M. H. M. L., Bull, C., & McGoon, D. C. (1988) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)35174-8 · Cited by 1,001 · see citing works
Haı̈ssaguerre, M., Hocini, M., Sanders, P., Sacher, F., Rotter, M., Takahashi, Y., Rostock, T., Hsu, L., Bordachar, P., Reuter, S., et al. (2005) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2005.00308.x · Cited by 755 · see citing works
Inferior vena cava-pulmonary artery extracardiac conduit
Marcelletti, C. F., Como, A. F., Giannico, S., et al. (1990) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)35562-x · Cited by 423 · see citing works
Inferior vena cava-pulmonary artery extracardiac conduit. A new form of right heart bypass.
Marcelletti, C. F., Corno, A. F., Giannico, S., et al. (1990) · PubMed · Cited by 406 · see citing works
d’Udekem, Y., Iyengar, A. J., Cochrane, A. D., Grigg, L., Ramsay, J., Wheaton, G. R., Penny, D. J., & Brizard, C. P. (2007) · Circulation · doi:10.1161/circulationaha.106.676445 · Cited by 370 · see citing works
A technique for the rapid diagnosis of atrial tachycardia in the electrophysiology laboratory
Knight, B. P., Zivin, A. H., Souza, J. J., Flemming, M. A., Pelosi, F., Goyal, R., Man, K. C., Strickberger, S. A., & Morady, F. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(98)00614-7 · Cited by 293 · see citing works
Right atrial-right ventricular anastomosis for correction of tricuspid atresia
Björk, V. O., Olin, C. L., Bjarke, B., et al. (1979) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(19)40916-1 · Cited by 267 · see citing works
Triedman, J. K., Alexander, M. E., Love, B. A., Collins, K. K., Berul, C. I., Bevilacqua, L. M., & Walsh, E. P. (2002) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(02)01858-2 · Cited by 260 · see citing works
Self-citationOuyang, F., Ernst, S., Vogtmann, T., Goya, M., Volkmer, M., Schaumann, A., Bänsch, D., Antz, M., & Kuck, K.-H. (2002) · Circulation · doi:10.1161/01.cir.0000015077.12680.2e · Cited by 212 · see citing works
Triedman, J. K., Bergau, D., Saul, J. P., Epstein, M. R., & Walsh, E. P. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00252-0 · Cited by 210 · see citing works
Self-citationArrhythmias in a Contemporary Fontan Cohort
Stephenson, E. A., Lü, M., Berul, C. I., Etheridge, S. P., Idriss, S. F., Margossian, R. E., Reed, J. H. C., Prakash, A., Sleeper, L. A., Vetter, V. L., et al. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.03.079 · Cited by 198 · see citing works
Deisenhofer, I., Zrenner, B., Yin, Y., et al. (2010) · Circulation · doi:10.1161/circulationaha.110.970350 · Cited by 171 · see citing works
González‐Torrecilla, E., Arenal, Á., Atienza, F., Osca, J., Fernandez, F., Puchol, A., Sánchez, A., & Almendral, J. M. (2006) · Heart Rhythm · doi:10.1016/j.hrthm.2006.02.019 · Cited by 152 · see citing works
EPSTEIN, M. R., Saul, J. P., Weindling, S. N., Triedman, J. K., & Walsh, E. P. (2001) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2001.00671.x · Cited by 128 · see citing works
Self-citationProcedure-Type Risk Categories for Pediatric and Congenital Cardiac Catheterization
Bergersen, L. J., Gauvreau, K., Marshall, A. C., Kreutzer, J. N., Beekman, R. H., Hirsch, R., Foerster, S. R., Balzer, D. T., Vincent, J., Hellenbrand, W. E., et al. (2011) · Circulation Cardiovascular Interventions · doi:10.1161/circinterventions.110.959262 · Cited by 123 · see citing works
Miles, W. M., Yee, R., Klein, G. J., et al. (1986) · Circulation · doi:10.1161/01.cir.74.3.493 · Cited by 116 · see citing works
Atrial flutter after lateral tunnel construction in the modified Fontan operation: A canine model
Rodefeld, M. D., Bromberg, B. I., Schuessler, R. B., Boineau, J. P., Cox, J. L., & Huddleston, C. B. (1996) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(96)70303-3 · Cited by 97 · see citing works
Rodefeld, M. D., Gandhi, S. K., Huddleston, C. B., Turken, B. J., Schuessler, R. B., Boineau, J. P., Cox, J. L., & Bromberg, B. I. (1996) · Journal of Thoracic and Cardiovascular Surgery · doi:10.1016/s0022-5223(96)70089-2 · Cited by 28 · see citing works
Spontaneous Atrial Flutter in a Chronic Canine Model of the Modified Fontan Operation
Gandhi, S. K., Bromberg, B. I., Rodefeld, M. D., et al. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00263-5 · Cited by 25 · see citing works
The Fontan/Kreutzer Procedure At 40: An Operation for the Correction of Tricuspid Atresia
Kreutzer, G. O. A., Schlichter, A. J., & Kreutzer, C. (2010) · Seminars in Thoracic and Cardiovascular Surgery Pediatric Cardiac Surgery Annual · doi:10.1053/j.pcsu.2010.01.002 · Cited by 23 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Epstein MR, Saul JP, Weindling SN, Triedman JK, Walsh EP. Atrioventricular reciprocating pu pu pu pulm lm lm lmon on on onar ar ar ary y y y ar ar ar arte te te tery ry ry S S Su Surg rg. m Y, Iyengar AJ, Cochrane AD, Grigg LE, Ramsay JM, Wheaton GR, Penny DJ P son EA, Lu M, Berul CI, Etheridge SP, Idriss SF, Margossian R, Reed JH, Praka A, Vetter VL, Blaufox AD, Pediatric Heart Network I. Arrhythmias in a contemp o J l 2010;56:890 896
Cited by
Sorted by citations
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403 · see citing works
- Authors
- Correa, R., Sherwin, E. D., Kovach, J., Mah, D. Y., Alexander, M. E., Cecchin, F., Walsh, E. P., Triedman, J. K., & Abrams, D. J.
- Affiliations
- Boston Children's Hospital (US)
- Corresponding author
- Sherwin, Elizabeth D.
- Kovach, Joshua
- ORCID
- Venue
- Circulation Arrhythmia and Electrophysiology
- Published
- 2015-04
- Volume
- 8
- Issue
- 2
- Pages
- 318-325
- ISSN
- 1941-3084 (ISSN-L)
- 1941-3149
- OpenAlex
- W1976257944
- Cited by
- 75
- References
- 22
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 2 · 2023: 4 · 2022: 7 · 2021: 3 · 2020: 4 · 2019: 5 · 2018: 9 · 2017: 16 · 2016: 7 · 2015: 6
- FWCI
- 9.21
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Arrhythmia and Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- 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 electrophysiology and arrhythmias
- Keywords
- total cavopulmonary connection, congenital heart disease, arrhythmia mechanisms, catheter ablation, atrial tachycardia, atrioventricular nodal reentrant tachycardia, ventricular tachycardia, macroreentrant tachycardia, accessory pathway, arrhythmia recurrence
- MeSH terms
- Action Potentials, Adolescent, Adult, Arrhythmias, Cardiac, Child, Female, Heart Defects, Congenital, Heart Rate, Humans, Male, Predictive Value of Tests, Recurrence, Retrospective Studies, Risk Factors, Severity of Illness Index, Time Factors, Treatment Outcome, Catheter Ablation, Heart Bypass, Right, Electrophysiologic Techniques, Cardiac, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
