Ilaria Cazzoli1, Clara Gunturiz-Beltran2, Silvia Guarguagli1, Rafael Alonso-Gonzalez3, Sonya V Babu-Narayan4, Konstantinos Dimopoulos3, Lorna Swan3, Anselm Uebing5, Michael A Gatzoulis3, Sabine Ernst6. 1. Department of Cardiology, Royal Brompton and Harefield Hospital, Imperial College London, United Kingdom. 2. Department of Cardiology, Royal Brompton and Harefield Hospital, Imperial College London, United Kingdom; Electrophysiology Unit, Hospital Clinic of Barcelona, Barcelona, Spain. 3. Adult and Congenital Heart Centre and Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospital, London, United Kingdom. 4. Department of Cardiology, Royal Brompton and Harefield Hospital, Imperial College London, United Kingdom; Cardiovascular Research Center, Royal Brompton and Harefield Hospital, National Heart and Lung Institute, Imperial College, London, United Kingdom. 5. Electrophysiology Unit, Hospital Clinic of Barcelona, Barcelona, Spain; Department of Paediatric Cardiology, University of Muenster, Muenster, Germany. 6. Department of Cardiology, Royal Brompton and Harefield Hospital, Imperial College London, United Kingdom. Electronic address: s.ernst@rbht.nhs.uk.
Abstract
INTRODUCTION: Arrhythmia contributes significantly to morbidity and mortality of patients with congenital heart disease (CHD) or cardiomyopathy (CMP). It also has the potential to worsen symptoms and is particularly detrimental to patients with advanced heart failure awaiting cardiac transplantation. We report our experience using catheter ablation to treat recurrent arrhythmia in patients with CHD or CMP considered for transplantation. METHODS: Five consecutive patients (3 female, mean age 47.8 ± 12.8 years) with complex CHD or CMP (tricuspid atresia, mitral atresia, double inlet left ventricle, arrhythmogenic right ventricular cardiomyopathy, left ventricular non-compaction) presented with either atrial (n = 3) or ventricular (n = 2) arrhythmias. All ablations were guided by three-dimensional (3D) electro-anatomical mapping, plus remote magnetic navigation in 3 patients. RESULTS: Patients underwent a median of 2 ablation procedures for a total number of 26 tachycardias. None of the 5 patients experienced further arrhythmia at a median of 939 days (range 4-1375) from their last ablation. During a median follow up of 31 months (range 1-70), three patients underwent successful transplantation at 1375, 1062 and 321 days following their last ablation. One patient with a Fontan circulation died from hepatic cancer and one from end-stage heart failure despite urgent transplant listing. CONCLUSIONS: Catheter ablation is feasible in complex cardiac patients considered for heart transplantation and should be offered for rhythm management and patient optimization until a suitable donor is found.
INTRODUCTION:Arrhythmia contributes significantly to morbidity and mortality of patients with congenital heart disease (CHD) or cardiomyopathy (CMP). It also has the potential to worsen symptoms and is particularly detrimental to patients with advanced heart failure awaiting cardiac transplantation. We report our experience using catheter ablation to treat recurrent arrhythmia in patients with CHD or CMP considered for transplantation. METHODS: Five consecutive patients (3 female, mean age 47.8 ± 12.8 years) with complex CHD or CMP (tricuspid atresia, mitral atresia, double inlet left ventricle, arrhythmogenic right ventricular cardiomyopathy, left ventricular non-compaction) presented with either atrial (n = 3) or ventricular (n = 2) arrhythmias. All ablations were guided by three-dimensional (3D) electro-anatomical mapping, plus remote magnetic navigation in 3 patients. RESULTS:Patients underwent a median of 2 ablation procedures for a total number of 26 tachycardias. None of the 5 patients experienced further arrhythmia at a median of 939 days (range 4-1375) from their last ablation. During a median follow up of 31 months (range 1-70), three patients underwent successful transplantation at 1375, 1062 and 321 days following their last ablation. One patient with a Fontan circulation died from hepatic cancer and one from end-stage heart failure despite urgent transplant listing. CONCLUSIONS: Catheter ablation is feasible in complex cardiac patients considered for heart transplantation and should be offered for rhythm management and patient optimization until a suitable donor is found.
Authors: Nkechi Christiana Arinze; Harry O Eyituoyo; Rieta N Aben; Dat P Vu; Daniel B Haithcock; Joseph Poku; Felix O Sogade Journal: Am J Case Rep Date: 2020-12-02