Abstrait

Transcatheter therapies for arrhythmias in patients with complex congenital heart disease

EK Grant & CI Berul

Arrhythmias are responsible for significant morbidity and mortality in patients with complex congenital heart disease (CHD). Pharmacologic antiarrhythmic therapy often proves ineffective or intolerable due to adverse side effect profile in a patient group consigned to lifelong treatment. Interventional electrophysiology procedures have revolutionized arrhythmia management in the CHD population since the introduction of transcatheter ablation in the late 1980s. Tremendous advances in electroanatomic mapping and ablation technology have led to increased procedural success in conjunction with a dramatically reduced risk profile to overcome the challenges of patient size, abnormalities of the intrinsic conduction system, mapping of arrhythmia in complex congenital cardiac malformations and limited access to surgically isolated cardiac chambers. Future interventional electrophysiology innovations are geared to provide further reduction in radiation exposure for the CHD population.