Transbaffle Mapping and Ablation for Atrial Tachycardias After Mustard, Senning, or Fontan Operations

Author:

Correa Rafael1,Walsh Edward P.1,Alexander Mark E.1,Mah Douglas Y.1,Cecchin Frank1,Abrams Dominic J.1,Triedman John K.1

Affiliation:

1. Boston Children's Hospital, Boston, MA

Abstract

Background In Fontan and atrial switch patients, transcatheter ablation is limited by difficult access to the pulmonary venous atrium. In recent years, transbaffle access ( TBA ) has been described, but limited data document its safety and utility. Methods and Results All ablative electrophysiological study cases of this population performed between J anuary 2006 and D ecember 2010 at B oston C hildren's H ospital were reviewed. Pre‐case and follow‐up clinical characteristics were documented. Adverse events were classified by severity and attributability to the intervention. We included 118 cases performed in 90 patients. TBA was attempted in 74 cases and was successful in 96%: in 20 via baffle leak or fenestration and in 51 (94%) of 54 using standard or radiofrequency transseptal techniques. There were 10 procedures with adverse events ranked as moderate or more severe. The event rate was similar in both groups ( TBA 8% versus non‐ TBA 9%, P =1), and no events were directly attributable to TBA . There was a trend to higher proportion of cases having a >5‐point drop in saturations from baseline in the TBA group versus the non‐ TBA group in Fontan cases (15% vs 0%, P =0.14). When cases with follow‐up >90 and >365 days were analyzed, the median initial arrhythmia score of 5 significantly changed −3 points in both time periods ( P ≤0.001). Conclusions TBA is feasible in this population; its use was not associated with a higher incidence of adverse events; and changes in clinical scores support its efficacy. Desaturation observed in some patients is of uncertain significance but warrants postablation monitoring and prospective study.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

Cited by 37 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3