Catheter ablation for atrial fibrillation in patients with the Marfan and Marfan-like syndromes.
Patients with the Marfan syndrome may pose a difficult challenge for catheter-based interventions due to frequent coexisting valve disease, potential delay in vascular healing and repair, and intra-atrial scar from prior cardiac surgery. We report a case series of four patients with Marfan or Marfan-like syndromes who underwent ablation for drug-refractory atrial fibrillation. Ultimately three of four patients remained in sinus rhythm, however most patients required multiple ablative attempts and long-term atrial flutter was common. Nonetheless, peri-procedural complications were minimal despite the connective tissue disorder and prosthetic valves in three of four patients. In conclusion, catheter ablation of AF in patients with Marfan syndrome is a viable option in those individuals refractory to conventional therapy.
Bunch
T Jared
TJ
Department of Internal Medicine, Mayo Clinic, Rochester, MN 55902, USA. bunch.thomas18@mayo.edu
Connolly
Heidi M
HM
Asirvatham
Samuel J
SJ
Brady
Peter A
PA
Gersh
Bernard J
BJ
Munger
Thomas M
TM
Shen
Win-Kuang
WK
Monahan
Kristi H
KH
Packer
Douglas L
DL
D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000175:diagnosis* / Q000601:surgery*; D008875:Middle Aged; D012086:Reoperation; D016896:Treatment Outcome