Acute and long-term outcome after catheter ablation of supraventricular tachycardia in patients after the Mustard or Senning operation for D-transposition of the great arteries.
OBJECTIVE
Data about the acute and long-term outcome of catheter ablation in patients with D-transposition of the great arteries (d-TGA) post-Mustard/Senning operation are scarce.


RESULTS
This single-centre retrospective analysis includes 26 patients (mean age 28.7 ± 6.7 years, 8 females) after Mustard (n = 15) or Senning (n = 11) operation who underwent catheter ablation for intra-atrial re-entrant tachycardia (IART) or atrioventricular nodal re-entrant tachycardia (AVNRT) from January 2004 to May 2011. The electrophysiological studies were performed using a three-dimensional mapping system (CARTO). Remote magnetic navigation (RMN) was available since 2008. Follow-up on an outpatient basis was conducted 3, 6, and 12 months after ablation and yearly thereafter. In the 26 patients, 34 procedures were performed (one procedure n = 19, two n = 6, and three n = 1). Overall, 34 tachycardia forms (IART n = 30; AVNRT n = 4) were ablated manually (n = 25) or by RMN (n = 9). Acute success reached in 29/34 forms (85.3%). Mean fluoroscopy time (FT) was 28.2 ± 20.7 min and mean procedure duration (PD) was 290.9 ± 107.6 min. After a mean follow-up of 34.1 ± 24.5 months, 25/26 (96.2%) patients were free from IART or AVNRT. In the nine RMN ablations (mean follow-up 14.2 ± 5.8 months) acute and long-term success was 100%. Fluoroscopy time and PD were significantly reduced using RMN compared with manual ablation (11.9 ± 6.2 vs. 34.6 ± 20.6 min, 225.7 ± 24.1 vs. 312 ± 118.2 min, P = 0.02).


CONCLUSIONS
Catheter ablation of IART or AVNRT in patients post-Mustard/Senning operation for d-TGA has a high acute success rate. The recurrence rate for IART is about 30%; however, after a second ablation, long-term results are excellent. Remote magnetic navigation seems to improve single-procedure acute and long-term success and significantly reduces FT and PD.
Deutsches Herzzentrum München, Lazarettstrasse. 36, 80636 Munich, Germany. cardiocardio2003@yahoo.com.cn
Jinjin
J
Wu
Isabel
I
Deisenhofer
Sonja
S
Ammar
Stephanie
S
Fichtner
Tilko
T
Reents
Pinjun
P
Zhu
Clemens
C
Jilek
Christof
C
Kolb
John
J
Hess
Gabriele
G
Hessling
D000328:Adult; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009204:Myocardial Revascularization / Q000009:adverse effects*; D019651:Plastic Surgery Procedures / Q000009:adverse effects*; D012086:Reoperation; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D014188:Transposition of Great Vessels / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome
Atrial switch procedure; Atrioventricular node re-entry tachycardia; Catheter ablation; Intra-atrial re-entry tachycardia; Transposition of great arteries