Catheter ablation of postincisional tachycardias: final solution or palliative treatment?

Česká verzia

Authors: P. Peichl
Authors place of work: Klinika kardiologie IKEM, Praha
Published in the journal: Kardiol Rev Int Med 2006, 8(Supplementum): 33-36

Summary

Patients after surgical correction of congenital heart disease and/or valve surgery are at risk of postincisional tachycardias. Scar tissue after the surgery creates a complex arrhythmogenic substrate for multiple reentrant tachycardias. In patients after right and/or left atriotomy, the impulse circulates around the postatriotomy scar. In case of Fontane procedure, the right atrium is usually dilatated with extensive scarring and variable reentry circuits. Patients after atrial correction of transposition of great arteries most commonly develop reentry around tricuspid annulus, however, the access to both atria is difficult. Ventricular postincisional tachycardias are usually associated with postventriculotomy scar. In principle, catheter ablation consists of interruption of reentry circuit by ablation line from the central obstacle to the neighboring anatomical barrier. To prevent of all forms of reentrant circuits, it is necessary to abolish all potential channels of slow conduction within the scar area. Modern electrophysiologic mapping systems enable exact characterization of the arrhythmogenic substrate and precise identification of target for radiofrequency ablation.

Key words:
catheter ablation - congenital heart disease - incisional tachycardias

Zdroje

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