Late Atrial Tachyarrhythmias After Repair of Congenital Heart Disease What is the Mechanism and How Can They Be Localized and Ablated?

Abstract

Supraventricular arrhythmias are often seen in patients who have undergone corrective surgery for congenital heart disease, and they are associated with elevated morbidity. Although atrial fibrillation is a common finding in such patients, many supraventricular arrhythmias take the form of reentrant atrial tachycardia and/or flutter [1–4]. Several recent papers have focused on the mechanisms and the characteristics of these arrhythmias. Because of the clear relationship between atrial reentrant tachycardias and the presence of scars or prosthetic materials they are called ‘incisional’ atrial tachycardias [5–13]. These arrhythmias can occur more frequently after correction of atrial septal defect, tetralogy of Fallot, Mustard and Senning or Fontan procedures [1–4].