Abstract
This chapter reviews the etiologies, mechanisms, and therapeutic approaches used for treatment of atrial tachycardias in patients with congenital heart disease (CHD). Intraatrial reentrant tachycardia (IART) is a prevalent long-term consequence of CHD. IART may manifest as typical atrial flutter, atypical macroreentrant atrial tachycardia, or atrial fibrillation. In addition to causing symptoms, IART appears to be associated with heart failure, thrombosis and thromboembolism, and reduced survival. Although prophylactic antiarrhythmic drugs and pacing strategies may be useful in selected patients, modification of the atrial substrate using advanced ablation techniques and surgical intervention in some cases are more likely to succeed as definitive therapy. Future challenges include increasing long-term success rates and development of strategies for definitive management of atrial fibrillation in these complex patients.
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