Logo image
Back
PO-01-035 CATHETER ABLATION FOR ATRIAL TACHYARRHYTHMIAS IN ADULTS WITH FONTAN PALLIATION: A MULTICENTER STUDY FROM THE PEDIATRIC AND CONGENITAL ELECTROPHYSIOLOGY SOCIETY (PACES) AND INTERNATIONAL SOCIETY FOR ADULT CONGENITAL HEART DISEASE (ISACHD)
Abstract   Peer reviewed

PO-01-035 CATHETER ABLATION FOR ATRIAL TACHYARRHYTHMIAS IN ADULTS WITH FONTAN PALLIATION: A MULTICENTER STUDY FROM THE PEDIATRIC AND CONGENITAL ELECTROPHYSIOLOGY SOCIETY (PACES) AND INTERNATIONAL SOCIETY FOR ADULT CONGENITAL HEART DISEASE (ISACHD)

Anna N. Kamp, Jeremy P. Moore, Victoria Shay, Chance Alvarado, Scott R. Ceresnak, Francis Bessiere, Benjamin Hale, Martin J. LaPage, Philip M. Chang, Thomas A. Pilcher, …
Heart rhythm, Vol.21(5 Supplement), pp.S215-S216
05/2024
DOI: 10.1016/j.hrthm.2024.03.694

View Online

Abstract

Background Atrial tachyarrhythmias (AT) are a common late manifestation after Fontan palliation and contribute to significant morbidity and mortality. Outcomes of AT ablation in adults with Fontan palliation have not been broadly evaluated using current-era technologies. Objective Evaluate the outcomes of current era AT ablation in adults with total cavopulmonary connection (TCPC) Fontan from an international cohort. Methods A retrospective, PACES/ISACHD multi-site study was conducted on patients >18 years of age with TCPC Fontan who underwent catheter ablation for AT between 2012 and 2022. Data were securely electronically collected on cardiac history, ablation procedures, outcomes, and follow-up. Primary outcomes included: 1) acute successful ablation and 2) occurrence of AT during follow-up. Fisher’s Exact tests were used to assess between-group differences. Holm’s method was used to correct for multiple comparisons. Results A total of 200 procedures for patients median age 28 years, 131 lateral Fontan (68%), 43 (22%) extracardiac conduit, single systemic LV 112 (56%), were enrolled from 15 international centers. Procedure characteristics are described in Table 1. More than 1 tachycardia was demonstrated in 56%. Acute successful ablation was achieved in 91%. AT requiring intervention occurred in 51% at median follow up 0.58 years (IQR 0.1, 2.15) after ablation. The occurrence of AT during follow-up was not associated with ventricular function, type of Fontan, transbaffle access, AV valve regurgitation, heterotaxy, or more than one tachycardia at the ablation procedure. Use of a multi-electrode mapping catheter was associated with fewer AT requiring intervention during follow-up. Conclusion In the current era of adult TCPC Fontan patients, the acute success rate for catheter ablation of AT exceeds 90%. Nevertheless, the arrhythmia burden remains substantial post-ablation, with over 50% experiencing an AT that requires intervention.

Details

Metrics

61 Record Views
Logo image