Raymond Pranata1, Alexander Edo Tondas2, Emir Yonas3, Veresa Chintya4, Muhammad Yamin5. 1. Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia. Electronic address: raymond_pranata@hotmail.com. 2. Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Sriwijaya, Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Electronic address: edotondas@fk.unsri.ac.id. 3. Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia. Electronic address: E_yonas@windowslive.com. 4. Faculty of Medicine, Universitas Kristen Krida Wacana, Jakarta, Indonesia. Electronic address: veresa.vc@gmail.com. 5. Division of Cardiology, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia/Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia. Electronic address: muhyam511@gmail.com.
Abstract
BACKGROUND: Prevalence of atrial fibrillation (AF) in patients with congenital heart disease (CHD) is on the rise. Anti-arrhythmic drugs are usually the first line of treatment in CHD, however, it is often ineffective and poorly tolerated. We aimed to perform a systematic review to assess the efficacy and safety of catheter ablation for AF in CHD. METHODS: We performed a comprehensive search on catheter ablation for atrial fibrillation in congenital heart disease up until July 2019 through several electronic databases. RESULTS: Ablation of AF in patients with CHD had a modest 12 months AF freedom ranging from 32.8% to 63%, which can be increased by subsequent/repeat ablation. The complexity of CHD appears to have a significant effect on a study but not in others. Catheter ablation in ASD and persistent left superior vena cava had a high success rate. Overall, catheter ablation is safe whichever the type of CHD is. CONCLUSION: Catheter ablation for AF in CHD had modest efficacy that can be increased by subsequent/repeat ablation and it also has an excellent safety profile. Ablation in complex CHD could also have similar efficacy, however, it is preferably done by experts in a high volume tertiary center.
BACKGROUND: Prevalence of atrial fibrillation (AF) in patients with congenital heart disease (CHD) is on the rise. Anti-arrhythmic drugs are usually the first line of treatment in CHD, however, it is often ineffective and poorly tolerated. We aimed to perform a systematic review to assess the efficacy and safety of catheter ablation for AF in CHD. METHODS: We performed a comprehensive search on catheter ablation for atrial fibrillation in congenital heart disease up until July 2019 through several electronic databases. RESULTS: Ablation of AF in patients with CHD had a modest 12 months AF freedom ranging from 32.8% to 63%, which can be increased by subsequent/repeat ablation. The complexity of CHD appears to have a significant effect on a study but not in others. Catheter ablation in ASD and persistent left superior vena cava had a high success rate. Overall, catheter ablation is safe whichever the type of CHD is. CONCLUSION: Catheter ablation for AF in CHD had modest efficacy that can be increased by subsequent/repeat ablation and it also has an excellent safety profile. Ablation in complex CHD could also have similar efficacy, however, it is preferably done by experts in a high volume tertiary center.
Authors: Charlotte A Houck; Natasja M S de Groot; Isabella Kardys; Christa D Niehot; Ad J J C Bogers; Elisabeth M J P Mouws Journal: J Am Heart Assoc Date: 2020-09-25 Impact factor: 5.501