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32. Cardiovascular Nursing
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Arrhythmia ablation in congenital heart disease patients – a single centre retrospective study
Session:
CO 18 - Cardiopatias Congénitas
Speaker:
Guilherme Lourenço
Congress:
CPC 2021
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
20. Congenital Heart Disease and Pediatric Cardiology
Subtheme:
20.4 Congenital Heart Disease – Treatment
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Guilherme Lourenço; Sérgio Laranjo; Ana Sofia Delgado; Conceição Trigo; Fátima f. Pinto; Rui Ferreira; Mário Oliveira
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Introduction:</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Arrhythmias are an important cause of morbidity and mortality in congenital heart disease (CHD) patients. They can be treated by ablation during electrophysiological studies, but are usually complex cases, due to the anatomical variation (pre and post-surgery) and presence of structural disease and scar tissue.</span></span></p> <p> </p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Methods:</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Retrospective review of ablation cases in CHD patients in a single centre from 2001 to 2020. Data on demographics, CHD group, arrhythmia mechanism, treatment outcomes (immediate and long term), and complications was collected.</span></span></p> <p> </p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Results:</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">53 patients were identified (51% male), who had a total of 77 procedures. Median age at first procedure was 29.8 years (min 0.7, max 65.8). The most prevalent CHD group was right obstructions (25 pts, 47.2%), followed by septal defects (13 pts, 24.5%), left obstructions (4 pts, 7.5%), tricuspid valve malformations (4 pts, 7.5%), functionally univentricular heart post-Fontan operation (4 pts, 7.5%), post-transposition of the great arteries post-Senning operation (2 pts, 3.8%) and Truncus arteriosus (1 pt, 1.9%). The median number of surgeries was 1 (min 0, max 4), and 12 pts (22.6%) underwent at least one palliative surgery. On the first procedure arrhythmias found were right atrial macroreentrant taquicardia (23 pts, 43.4%), right atrial focal tachycardia (4 pts, 7.5%), left atrial focal tachycardia (1 pt, 1.9%), atrial fibrillation (4 pts, 7.5%), accessory pathway-mediated atrioventricular (AV) reentrant tachycardia (7 pts, 13.2%), AV nodal reentrant tachycardia (4 pts, 7.5%), right ventricular focal tachycardia (3 pts, 5.7%), right ventricular macroreentrant tachycardia (4 pts, 7.5%), presence of substrate for right ventricular macroreentrant tachycardia without clinical manifestations (1 pt, 1.9%), and non-specified atrial tachycardia (2 pts, 3.8%). On first procedure complete success was achieved in 81.1% of patients, partial success occurred in 3.8% and empirical treatment was performed in 1.9% (1 pt); palliative treatment (AV node ablation) was performed in 3.8%; procedure failure occurred in 7.5%. Recurrence of (any) arrhythmia occurred in 39.6%, but of these 28.6% were of a different mechanism. 18 patients had at least one repeat procedure, and on the first repeat procedure complete success was achieved in 72.2%.</span></span></p> <p> </p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Conclusion:</span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">CHD patients present a challenging population, but on our series it was possible to treat their arrhythmias, even tough multiple procedures were frequently necessary.</span></span></p>
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