scholarly journals Radiofrequency ablation of supraventricular tachycardias in patients with congenital heart disease and difficult access to the chamber of interest using remote magnetic navigation

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P4922-P4922
Author(s):  
L. Mantziari ◽  
A. Ueda ◽  
I. Suman-Horduna ◽  
S. Y. Ho ◽  
S. Babu-Narayan ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Radiofrequency Ablation ◽  
Congenital Heart ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation ◽  
Supraventricular Tachycardias

scholarly journals Radiofrequency catheter ablation for ventricular tachycardia using robotic magnetic navigation technology in a teenager after surgery of congenital heart disease and transcatheter closure of ventricular septal defect using an occluder: a case report

2021 ◽  
Vol 26 (8) ◽  
pp. 4229
Author(s):  
A. V. Ponomarenko ◽  
Egor Alexeyevich Morzhanaev ◽  
I. L. Mikheenko ◽  
A. B. Romanov
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Ventricular Tachycardia ◽  
Case Report ◽  
Radiofrequency Ablation ◽  
Ventricular Septal Defect ◽  
Congenital Heart ◽  
Septal Defect ◽  
Transcatheter Closure ◽  
Magnetic Navigation

Introduction. The case report describes radiofrequency ablation of ventricular tachycardia (VT) using robotic magnetic navigation (RMN) in a teenager after surgery of congenital heart disease (CHD) and transcatheter closure of ventricular septal defect (VSD) using an occluder.Short description. The 16-year-old female patient was operated on in 2005 for CHD. In 2018, the patient underwent resection of ascending aortic sub-valvular membrane, followed by transcatheter closure of VSD with an occluder. After surgery, VT of 294 bpm was documented, which required an emergency hospitalization. Decision was taken to perform a radiofrequency ablation (RFA) using RMN. RFA was performed from the pulmonary artery valve through the scar to upper occluder edge spreading to tricuspid valve. After procedure, VT paroxysms were not induced with all pacing types. According to ECG series and 24-hour Holter monitoring on the 2nd day after surgery, VT episodes were not recorded. During the 6-month follow-up period, VT episodes were not registered without taking antiarrhythmic drugs.Discussion. This case report demonstrates the effectiveness of using RMN system for VT ablation in a teenager with CHD, who underwent open surgical interventions and transcatheter VSD closure using an occluder.

Acute and Long-Term Outcomes of Catheter Ablation Using Remote Magnetic Navigation in Patients With Congenital Heart Disease

2012 ◽  
Vol 110 (3) ◽  
pp. 409-414 ◽  
Author(s):  
Ferdi Akca ◽  
Tamas Bauernfeind ◽  
Maarten Witsenburg ◽  
Lara Dabiri Abkenari ◽  
Judith A. Cuypers ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Catheter Ablation ◽  
Congenital Heart ◽  
Magnetic Navigation ◽  
Long Term Outcomes ◽  
Remote Magnetic Navigation

scholarly journals Remote magnetic navigation for heart rhythm disturbances treatment in patients after surgical correction of congenital heart disease

2021 ◽  
Vol 25 (1) ◽  
pp. 32
Author(s):  
V. V. Beloborodov ◽  
N. A. Elemesov ◽  
A. V. Ponomarenko ◽  
E. A. Morzhanaev ◽  
A. G. Filippenko ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Conflict Of Interest ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Rhythm ◽  
Surgical Correction ◽  
Published Data ◽  
Magnetic Navigation ◽  
Remote Magnetic Navigation

<p>The prevalence of congenital heart diseases is nine persons per 1000. Sometimes, congenital heart disease needs surgical correction. The long-term postoperative period is often associated with complex heart rhythm disturbances like ectopic or re-entry tachycardia. These cases, in combination with difficult anatomy, results in challenges during interventional treatment. Catheter ablation has been demonstrated as safe and effective in different types of arrhythmia treatments in such patients, including paediatric cohorts. Despite these facts, several important problems regarding using current technologies are still unresolved. Remote magnetic navigation showed good results regarding localisation of arrhythmogenic zones during treatment of complex heart rhythm disturbances. The objective of the present article is to review recently published data in this area and experience of Meshalkin National Medical Research Center in heart rhythm disturbances treatment using remote magnetic navigation in patients after surgical correction of congenital heart disease.</p><p>Received 28 September 2020. Revised 25 December 2020 г. Accepted 30 December 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and study design: A.B. Romanov, A.M. Chernyavskiy<br />Drafting the article: V.V. Beloborodov, А.V. Ponomarenko, E.А. Morzhanaev<br />Critical revision of the article: A.B. Romanov, А.V. Ponomarenko, I.L. Mikheenko, E.А. Morzhanaev, A.G. Filippenko, <br />A.M. Chernyavskiy<br />Final approval of the version to be published: V.V. Beloborodov, N.А. Yelemessov, А.V. Ponomarenko, E.А. Morzhanaev, <br />A.G. Filippenko, I.L. Mikheenko, A.M. Chernyavskiy, A.B. Romanov</p>

scholarly journals Treatment of symptomatic atrial tachycardia in complex anatomic conditions: use and outcome of ablation in patients after damus-kaye-stansel surgery

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
AJ Fischer ◽  
SY Ho ◽  
S Ernst
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Aortic Valve ◽  
Congenital Heart ◽  
Three Dimensional ◽  
Magnetic Navigation ◽  
Image Integration ◽  
Ventricular Ejection Fraction ◽  
Remote Magnetic Navigation ◽  
Dimensional Image

Abstract Funding Acknowledgements Type of funding sources: None. Background Atrial tachycardias (AT) are amongst the most frequent complications in adult patients with congenital heart disease (ACHD). Their incidence mainly depends on age and complexity of underlying defect. AT has a marked impact on morbidity and mortality and is associated with sudden cardiac death particularly in complex ACHD patients. The arrhythmic substrate can be variable from re-entry to multifocal resulting in demanding requirements for electrophysiologic ablation procedures (EP) and thus, relatively high rates of recurrence. Methods and results Retrospective analysis of ACHD patients with prior Damus-Kaye-Stansel (DKS) surgery treated at one of the largest specialized tertiary centers for ACHD patients worldwide. Analysis focussed on occurrence of AT, respective treatment and outcome of EP. Over a median observation time of 15 years, 13 patients with prior DKS surgery and complex congenital heart defects of different types but uniformly Fontan circulation, were identified (median age 22.0 years (IQR 20.5 – 25.5), 76.9% male, 92.3% NYHA Class I, median systemic ventricular ejection fraction 58.5%, 69.2% extracardiac tunnel). Seven patients (53.8%) presented with symptomatic AT (median cyclic length 440 ms (IQR 360.0 – 517.5)). Of these, six patients underwent EP. Median procedure time was 180.5 min (IQR 160.8 – 274.5), median fluoroscopy time 1.56 min (IQR 0.51 – 4.73) and radiofrequency time 851 sec (265.0 -2005.0). Remote magnetic navigation was used to access ablation site through a retrograde access via the aortic as well as the neo-aortic valve.  Three-dimensional image integration aided in mapping and ablation. Throughout the procedure as well as in follow-up visits, no reportable complications were observed. After a mean of 1.5 procedures, all analysed patients stayed complaint-free throughout a median time-interval of 13 months. Conclusion AT are frequent in complex univentricular situations after Damus-Kaye-Stansel surgery (53.8%). Although more than one procedure (mean 1.5) was necessary to achieve satisfactory results even in experienced hands, EP appears to be an appropriate treatment strategy in this young and otherwise healthy patient cohort. According to our analysis, EP is feasible and safe in centers with knowledge of specific anatomic characteristics of congenital heart disease and when the appropriate technical infrastructure is present. Access to ablation site was performed by remote magnetic navigation in the majority of procedures. The floppy catheter was navigated through the neo-aortic as well as through the aortic valve without observable peri- or postinterventional complications. Mapping with three-dimensional image integration facilitated EP and led to a relatively low radiation exposure with the known benefits for the patient as well as for the healthcare professionals involved in the procedure. Abstract Figure.

Efficacy of Antiarrhythmic Drugs in Adults With Congenital Heart Disease and Supraventricular Tachycardias

2013 ◽  
Vol 112 (9) ◽  
pp. 1461-1467 ◽  
Author(s):  
Zeliha Koyak ◽  
Bart Kroon ◽  
Joris R. de Groot ◽  
Lodewijk J. Wagenaar ◽  
Arie P. van Dijk ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Antiarrhythmic Drugs ◽  
Supraventricular Tachycardias

Invasive electrophysiological studies in adult congenital heart disease- evolving use and impact of specialized centre therapy on recurrence of arrhythmia: a nationwird analysis based on 2.433 cases

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.J Fischer ◽  
D Enders ◽  
H Baumgartner ◽  
G.P Diller
Keyword(s):  
Atrial Fibrillation ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Real World ◽  
Congenital Heart ◽  
Complex Disease ◽  
Annual Number ◽  
Electrophysiological Studies ◽  
Supraventricular Tachycardias ◽  
The Impact

Abstract Background Arrhythmias are a major contributor to morbidity and mortality in adult patients with congenital heart disease (ACHD). Advances in ablation technology have contributed to improved management and reduction of symptoms in this population. However, only limited data exist on the use and outcome of these technologies in large community-based cohorts of ACHD patients and on the impact of specialized centres on recurrence of arrhythmias. Purpose We performed a retrospective analysis based on data from one of the largest German Health Insurance Companies (approx. 9 million insured members), acquiring real-world data on frequency of invasive electrophysiological studies (EPS) in Germany between 2005 and 2018. ACHD patients were identified based on ICD codes and the spectrum of disease as well as the impact of EPS being performed at specialized ACHD centres was analysed. Results Out of 45,761 eligible ACHD patients in the database, we identified 2,433 EPS performed in 1,706 ACHD (51% female, median age 55.4 years, complexity of CHD mild, moderate and severe in 50.6%, 33.2%,16.2%, respectively). Over the study period the annual number of EPS increased by 207%. The majority of procedures were for supraventricular tachycardias (85.9%). Of these procedures atrial fibrillation accounted for 35.1%, atrial flutter for 29.4% and other supraventricular tachycardias/pre-excitation syndromes for 29.9% of cases. The majority of EPS (64.3%) was performed at non-specialized centres including 40.2% of cases in patients with complex disease. Overall, the re- intervention rate within 12 months of the primary EPS was 14.5%. Whereas in ACHD patients with simple and moderate complexity disease no obvious difference in 12-months re- intervention rate was observed between specialized and non-specialised centres (15.5% vs. 15.0%), in patients with complex disease the reintervention rate was 41.6% higher for non-specialized centres (13.6% vs. 9.6%). Conclusion Our large real- world analysis shows an increasing need for invasive electrophysiological studies in ACHD patients. The vast majority of procedures was performed for supraventricular arrhythmias including in atrial fibrillation and flutter ablation. Re-interventions were frequently required in this unique and anatomically challenging population. Alarmingly, many procedures were performed at non-specialized centres, although current guidelines recommend that interventions in complex patients should remain reserved for experienced high-volume centres. Funding Acknowledgement Type of funding source: None

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