Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease: A Single-Center Experience in 116 Patients
BACKGROUND—Remote magnetic navigation–guided ablation with 3-dimensional (3D)-image integration could provide maximum benefit in patients with complex anatomy. We reviewed supraventricular tachycardia (SVT) ablation in adult patients with congenital heart disease to assess the contribution of these...
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| Veröffentlicht in: | Circulation. Arrhythmia and electrophysiology 2013-06, Vol.6 (3), p.606-613 |
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| container_title | Circulation. Arrhythmia and electrophysiology |
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| creator | Ueda, Akiko Suman-Horduna, Irina Mantziari, Lilian Gujic, Marko Marchese, Procolo Ho, Siew Yen Babu-Narayan, Sonya V Ernst, Sabine |
| description | BACKGROUND—Remote magnetic navigation–guided ablation with 3-dimensional (3D)-image integration could provide maximum benefit in patients with complex anatomy. We reviewed supraventricular tachycardia (SVT) ablation in adult patients with congenital heart disease to assess the contribution of these technologies.
METHODS AND RESULTS—One hundred fifty-four SVT ablation procedures (228 SVTs) using a 3D-electroanatomic mapping system in 116 adult patients with congenital heart disease (mean age, 41; 76 male) were classified into 3 groupsGroup A, manual mapping/ablation (n=60 procedures); Group B, remote magnetic navigation–guided mapping/ablation with normal femoral vein access (49); and Group C, remote magnetic navigation–guided mapping/ablation with difficult access (45). Group A included simple anomalies with less SVTs. Group B comprised predominantly Fontan patients with more SVTs. Group C included more complex defects, such as intra-atrial baffle or interrupted inferior venous access, in which retrograde aortic and superior venous accesses were used exclusively with more frequent use of image integration (97.8%; P |
| doi_str_mv | 10.1161/CIRCEP.113.000415 |
| format | Article |
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METHODS AND RESULTS—One hundred fifty-four SVT ablation procedures (228 SVTs) using a 3D-electroanatomic mapping system in 116 adult patients with congenital heart disease (mean age, 41; 76 male) were classified into 3 groupsGroup A, manual mapping/ablation (n=60 procedures); Group B, remote magnetic navigation–guided mapping/ablation with normal femoral vein access (49); and Group C, remote magnetic navigation–guided mapping/ablation with difficult access (45). Group A included simple anomalies with less SVTs. Group B comprised predominantly Fontan patients with more SVTs. Group C included more complex defects, such as intra-atrial baffle or interrupted inferior venous access, in which retrograde aortic and superior venous accesses were used exclusively with more frequent use of image integration (97.8%; P<0.001). Acute success was 91.5%, 83.7%, and 82.2%, respectively (P=0.370). In group C, fluoroscopy time was the shortest (median, 4.2 min; P<0.001) despite the longer procedure duration (median, 253 min; P<0.001). SVTs free rates were 80.4%, 82.4%, and 75.8%, respectively (P=0.787) during a mean 20-months follow-up period.
CONCLUSIONS—The combination of remote magnetic navigation, 3D-image integration, and electroanatomic mapping system facilitated safe and feasible ablation with very low fluoroscopy exposure even in patients with complex anomalies.</description><identifier>ISSN: 1941-3149</identifier><identifier>EISSN: 1941-3084</identifier><identifier>DOI: 10.1161/CIRCEP.113.000415</identifier><identifier>PMID: 23685536</identifier><language>eng</language><publisher>United States: American Heart Association, Inc</publisher><subject>Adult ; Analysis of Variance ; Body Surface Potential Mapping ; Cardiac Catheterization - methods ; Catheter Ablation ; Cohort Studies ; Electrocardiography, Ambulatory - methods ; Female ; Heart Defects, Congenital - complications ; Heart Defects, Congenital - diagnosis ; Heart Defects, Congenital - surgery ; Humans ; Imaging, Three-Dimensional ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Postoperative Care ; Prognosis ; Prospective Studies ; Risk Assessment ; Severity of Illness Index ; Statistics, Nonparametric ; Tachycardia, Supraventricular - complications ; Tachycardia, Supraventricular - diagnosis ; Tachycardia, Supraventricular - surgery ; Treatment Outcome</subject><ispartof>Circulation. Arrhythmia and electrophysiology, 2013-06, Vol.6 (3), p.606-613</ispartof><rights>2013 American Heart Association, Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2995-eb489cc5f479fd6bbd818806ee61f3922aa5b6cb80210dc8bf88e23b2fcaddb83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3685,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23685536$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ueda, Akiko</creatorcontrib><creatorcontrib>Suman-Horduna, Irina</creatorcontrib><creatorcontrib>Mantziari, Lilian</creatorcontrib><creatorcontrib>Gujic, Marko</creatorcontrib><creatorcontrib>Marchese, Procolo</creatorcontrib><creatorcontrib>Ho, Siew Yen</creatorcontrib><creatorcontrib>Babu-Narayan, Sonya V</creatorcontrib><creatorcontrib>Ernst, Sabine</creatorcontrib><title>Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease: A Single-Center Experience in 116 Patients</title><title>Circulation. Arrhythmia and electrophysiology</title><addtitle>Circ Arrhythm Electrophysiol</addtitle><description>BACKGROUND—Remote magnetic navigation–guided ablation with 3-dimensional (3D)-image integration could provide maximum benefit in patients with complex anatomy. We reviewed supraventricular tachycardia (SVT) ablation in adult patients with congenital heart disease to assess the contribution of these technologies.
METHODS AND RESULTS—One hundred fifty-four SVT ablation procedures (228 SVTs) using a 3D-electroanatomic mapping system in 116 adult patients with congenital heart disease (mean age, 41; 76 male) were classified into 3 groupsGroup A, manual mapping/ablation (n=60 procedures); Group B, remote magnetic navigation–guided mapping/ablation with normal femoral vein access (49); and Group C, remote magnetic navigation–guided mapping/ablation with difficult access (45). Group A included simple anomalies with less SVTs. Group B comprised predominantly Fontan patients with more SVTs. Group C included more complex defects, such as intra-atrial baffle or interrupted inferior venous access, in which retrograde aortic and superior venous accesses were used exclusively with more frequent use of image integration (97.8%; P<0.001). Acute success was 91.5%, 83.7%, and 82.2%, respectively (P=0.370). In group C, fluoroscopy time was the shortest (median, 4.2 min; P<0.001) despite the longer procedure duration (median, 253 min; P<0.001). SVTs free rates were 80.4%, 82.4%, and 75.8%, respectively (P=0.787) during a mean 20-months follow-up period.
CONCLUSIONS—The combination of remote magnetic navigation, 3D-image integration, and electroanatomic mapping system facilitated safe and feasible ablation with very low fluoroscopy exposure even in patients with complex anomalies.</description><subject>Adult</subject><subject>Analysis of Variance</subject><subject>Body Surface Potential Mapping</subject><subject>Cardiac Catheterization - methods</subject><subject>Catheter Ablation</subject><subject>Cohort Studies</subject><subject>Electrocardiography, Ambulatory - methods</subject><subject>Female</subject><subject>Heart Defects, Congenital - complications</subject><subject>Heart Defects, Congenital - diagnosis</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Care</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Severity of Illness Index</subject><subject>Statistics, Nonparametric</subject><subject>Tachycardia, Supraventricular - complications</subject><subject>Tachycardia, Supraventricular - diagnosis</subject><subject>Tachycardia, Supraventricular - surgery</subject><subject>Treatment Outcome</subject><issn>1941-3149</issn><issn>1941-3084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFu1DAURS1ERUvhA9ggL9mk-NmJx2E3ClNaqVIrWtaR7bx0DE4c7IS2P8B34yoty658Jd97pHcI-QDsBEDC5-b8e7O7ylmcMMZKqF6RI6hLKART5evnDGV9SN6m9JMxCQrkG3LIhVRVJeQR-duEccZhClHHB3q5zDYMmGjo6fUyRf0Hxzk6u3gd6Y22-werY-c03RqvZxdG6kaaCbc4ull7eoY6zvSrS6gTfqFbeu3GW49FkzEY6e5-wuhwtPi4yyfQq0zJf-kdOei1T_j-6T0mP053N81ZcXH57bzZXhSW13VVoClVbW3Vl5u676QxnQKlmESU0Iuac60rI61RjAPrrDK9UsiF4b3VXWeUOCafVu4Uw-8F09wOLln0Xo8YltSC2DDgJa83uQpr1caQUsS-naIbsqUWWPuov1315yzaVX_efHzCL2bA7v_i2XcuVGvhLvhsJP3yyx3Gdo_az_sXwP8AvZmTqw</recordid><startdate>201306</startdate><enddate>201306</enddate><creator>Ueda, Akiko</creator><creator>Suman-Horduna, Irina</creator><creator>Mantziari, Lilian</creator><creator>Gujic, Marko</creator><creator>Marchese, Procolo</creator><creator>Ho, Siew Yen</creator><creator>Babu-Narayan, Sonya V</creator><creator>Ernst, Sabine</creator><general>American Heart Association, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201306</creationdate><title>Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease: A Single-Center Experience in 116 Patients</title><author>Ueda, Akiko ; Suman-Horduna, Irina ; Mantziari, Lilian ; Gujic, Marko ; Marchese, Procolo ; Ho, Siew Yen ; Babu-Narayan, Sonya V ; Ernst, Sabine</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2995-eb489cc5f479fd6bbd818806ee61f3922aa5b6cb80210dc8bf88e23b2fcaddb83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Analysis of Variance</topic><topic>Body Surface Potential Mapping</topic><topic>Cardiac Catheterization - methods</topic><topic>Catheter Ablation</topic><topic>Cohort Studies</topic><topic>Electrocardiography, Ambulatory - methods</topic><topic>Female</topic><topic>Heart Defects, Congenital - complications</topic><topic>Heart Defects, Congenital - diagnosis</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Care</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Severity of Illness Index</topic><topic>Statistics, Nonparametric</topic><topic>Tachycardia, Supraventricular - complications</topic><topic>Tachycardia, Supraventricular - diagnosis</topic><topic>Tachycardia, Supraventricular - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ueda, Akiko</creatorcontrib><creatorcontrib>Suman-Horduna, Irina</creatorcontrib><creatorcontrib>Mantziari, Lilian</creatorcontrib><creatorcontrib>Gujic, Marko</creatorcontrib><creatorcontrib>Marchese, Procolo</creatorcontrib><creatorcontrib>Ho, Siew Yen</creatorcontrib><creatorcontrib>Babu-Narayan, Sonya V</creatorcontrib><creatorcontrib>Ernst, Sabine</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ueda, Akiko</au><au>Suman-Horduna, Irina</au><au>Mantziari, Lilian</au><au>Gujic, Marko</au><au>Marchese, Procolo</au><au>Ho, Siew Yen</au><au>Babu-Narayan, Sonya V</au><au>Ernst, Sabine</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease: A Single-Center Experience in 116 Patients</atitle><jtitle>Circulation. Arrhythmia and electrophysiology</jtitle><addtitle>Circ Arrhythm Electrophysiol</addtitle><date>2013-06</date><risdate>2013</risdate><volume>6</volume><issue>3</issue><spage>606</spage><epage>613</epage><pages>606-613</pages><issn>1941-3149</issn><eissn>1941-3084</eissn><abstract>BACKGROUND—Remote magnetic navigation–guided ablation with 3-dimensional (3D)-image integration could provide maximum benefit in patients with complex anatomy. We reviewed supraventricular tachycardia (SVT) ablation in adult patients with congenital heart disease to assess the contribution of these technologies.
METHODS AND RESULTS—One hundred fifty-four SVT ablation procedures (228 SVTs) using a 3D-electroanatomic mapping system in 116 adult patients with congenital heart disease (mean age, 41; 76 male) were classified into 3 groupsGroup A, manual mapping/ablation (n=60 procedures); Group B, remote magnetic navigation–guided mapping/ablation with normal femoral vein access (49); and Group C, remote magnetic navigation–guided mapping/ablation with difficult access (45). Group A included simple anomalies with less SVTs. Group B comprised predominantly Fontan patients with more SVTs. Group C included more complex defects, such as intra-atrial baffle or interrupted inferior venous access, in which retrograde aortic and superior venous accesses were used exclusively with more frequent use of image integration (97.8%; P<0.001). Acute success was 91.5%, 83.7%, and 82.2%, respectively (P=0.370). In group C, fluoroscopy time was the shortest (median, 4.2 min; P<0.001) despite the longer procedure duration (median, 253 min; P<0.001). SVTs free rates were 80.4%, 82.4%, and 75.8%, respectively (P=0.787) during a mean 20-months follow-up period.
CONCLUSIONS—The combination of remote magnetic navigation, 3D-image integration, and electroanatomic mapping system facilitated safe and feasible ablation with very low fluoroscopy exposure even in patients with complex anomalies.</abstract><cop>United States</cop><pub>American Heart Association, Inc</pub><pmid>23685536</pmid><doi>10.1161/CIRCEP.113.000415</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1941-3149 |
| ispartof | Circulation. Arrhythmia and electrophysiology, 2013-06, Vol.6 (3), p.606-613 |
| issn | 1941-3149 1941-3084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1370124297 |
| source | MEDLINE; American Heart Association Journals; EZB-FREE-00999 freely available EZB journals |
| subjects | Adult Analysis of Variance Body Surface Potential Mapping Cardiac Catheterization - methods Catheter Ablation Cohort Studies Electrocardiography, Ambulatory - methods Female Heart Defects, Congenital - complications Heart Defects, Congenital - diagnosis Heart Defects, Congenital - surgery Humans Imaging, Three-Dimensional Magnetic Resonance Imaging - methods Male Middle Aged Postoperative Care Prognosis Prospective Studies Risk Assessment Severity of Illness Index Statistics, Nonparametric Tachycardia, Supraventricular - complications Tachycardia, Supraventricular - diagnosis Tachycardia, Supraventricular - surgery Treatment Outcome |
| title | Contemporary Outcomes of Supraventricular Tachycardia Ablation in Congenital Heart Disease: A Single-Center Experience in 116 Patients |
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