Management of Atrial Tachyarrhythmias in Adults With Single Ventricle Heart Disease

Purpose of review In this manuscript, we review the modifications to the Fontan operation along with the incidence, etiology, and outcomes of atrial tachyarrhythmias in adults with single ventricle heart disease. Medical, interventional, device, and surgical management of these arrhythmias is discussed in detail. Recent findings Atrial tachyarrhythmias are the most common late complication following the Fontan operation present in > 50% of patients 20 years after palliation. Management of these arrhythmias is difficult, but advances in device and electrophysiology technology have made treatment more successful. For patients with atrio-pulmonary Fontan circulation, Fontan conversion surgery may be warranted. Summary Atrial tachyarrhythmias in adults with single ventricle heart disease are very common and associated with poor outcomes. The etiology of these dysrhythmias is multifactorial and change over time. Treatment of atrial tachyarrhythmias in this population is challenging, involving both medical and invasive therapies, and recurrence is common. These complex patients are best served by a multi-disciplinary team involving adult congenital cardiologists and congenital heart disease interventionalist and surgeons.