Importance of tachycardia cycle length for differentiating typical atrial flutter from scar-related in adult congenital heart disease
- Authors
- Uhm J.-S.; Mun H.-S.; Wi J.; Shim J.; Hwang H.J.; Sung J.-H.; Kim J.-Y.; Pak H.-N.; Lee M.-H.; Joung B.
- Issue Date
- 2012
- Keywords
- atrial flutter; cavotricuspid isthmus; congenital heart disease; intraatrial reentrant tachycardia; scar-related
- Citation
- PACE - Pacing and Clinical Electrophysiology, v.35, no.11, pp 1338 - 1347
- Pages
- 10
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- PACE - Pacing and Clinical Electrophysiology
- Volume
- 35
- Number
- 11
- Start Page
- 1338
- End Page
- 1347
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/12780
- DOI
- 10.1111/j.1540-8159.2012.03494.x
- ISSN
- 0147-8389
1540-8159
- Abstract
- Background: Radiofrequency catheter ablation (RFCA) for intraatrial reentrant tachycardia (IART) in congenital heart disease (CHD) remains difficult. Methods: Thirty-four consecutive adult patients (age, 37.6 ± 12.8 years; male, 21) with previously repaired CHD and IART underwent an electrophysiological study and RFCA. CHD included atrial septal defect (ASD, n = 14), tetralogy of Fallot (n = 11), ventricular septal defect (n = 4), pulmonary atresia (n = 2), atrioventricular septal defect (n = 1), transposition of the great arteries (n = 1), and double-outlet right ventricle (n = 1). Results: Duration of CHD repair to IART onset was 19.1 ± 8.5 years. Thirty and four patients had single- and double-loop reentrant tachycardia, respectively. Among the total of 38 IARTs, which were mapped, 22 (57.9%) and 13 (34.2%) IARTs were cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) and scar-related AFL, respectively. Typical AFL electrocardiography findings including definite sawtooth appearance in inferior leads and positive F wave in lead V1 were observed in only 12 of 21 patients (57.1%) with CTI-dependent AFL. CTI-dependent AFL had a significantly longer tachycardia cycle length (TCL) than scar-related AFL (267.6 ± 34.4 ms and 235.9 ± 37.0 ms, respectively; P = 0.031). TCL > 250 ms had 79% sensitivity as the cutoff value for differentiating CTI-dependent from scar-related AFL. The acute success rates of RFCA in CTI-dependent and scar-related AFLs were 85.7% and 90.0%, respectively. The recurrence rates in CTI-dependent and scar-related AFLs were 11.1% and 11.1%, respectively, during a follow-up of 21.2 ± 28.3 months. Conclusions: CTI-dependent AFL was the most common IART in adult patients with repaired CHD and was easily manageable by RFCA. TCL might help to differentiate CTI-dependent AFL from other IARTs. (PACE 2012;35:1338-1347) © 2012, The Authors. Journal compilation © 2012 Wiley Periodicals, Inc.
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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