Document Detail

Magnetic navigation in adults with atrial isomerism (heterotaxy syndrome) and supraventricular arrhythmias.
MedLine Citation:
PMID:  23355132     Owner:  NLM     Status:  MEDLINE    
AIMS: We analysed the type and mechanism of supraventricular arrhythmias encountered in a series of symptomatic adults with atrial isomerism undergoing catheter ablation procedures.
METHODS AND RESULTS: The study population included consecutive adults with atrial isomerism who had previously undergone surgical repair or palliation of the associated anomalies. Patients underwent electrophysiological study for symptomatic arrhythmia in our institution between 2010 and 2012 using magnetic navigation in conjunction with CARTO RMT and three-dimensional (3D) image integration. Eight patients (five females) with a median age of 33 years [interquartile range (IQR) 24-39] were studied. Access to the cardiac chambers of interest was obtained retrogradely via the aorta using remotely navigated magnetic catheters in six patients. Radiofrequency ablation successfully targeted twin atrioventricular (AV) nodal reentrant tachycardia in two patients, atrial fibrillation (AF) in three, focal atrial tachycardia (AT) mainly originating in the left-sided atrium in four patients, and macro-reentrant AT dependent on a right-sided inferior isthmus in three patients. The median fluoroscopy time was 3.0 min (IQR 2-11). After a median follow-up of 10 months (IQR 6-21), five of the ablated patients are free from arrhythmia; two patients experienced episodes of self-terminated AF and AT, respectively, within one month post-ablation; the remaining patient had only non-sustained AT during the electrophysiological study and was managed medically.
CONCLUSION: Various supraventricular tachycardia mechanisms are possible in adults with heterotaxy syndrome, all potentially amenable to radiofrequency ablation. The use of remote magnetic navigation along with 3D mapping facilitated the procedures and resulted in a short radiation time.
Irina Suman-Horduna; Sonya V Babu-Narayan; Akiko Ueda; Lilian Mantziari; Marko Gujic; Procolo Marchese; Konstantinos Dimopoulos; Michael A Gatzoulis; Michael L Rigby; Siew Yen Ho; Sabine Ernst
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-01-25
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  15     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-27     Completed Date:  2014-01-22     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  877-85     Citation Subset:  IM    
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MeSH Terms
Body Surface Potential Mapping / methods*
Heterotaxy Syndrome / diagnosis*,  surgery*
Magnetics / methods*
Surgery, Computer-Assisted / methods*
Tachycardia, Supraventricular / diagnosis*,  surgery*
Treatment Outcome
Young Adult
Grant Support
FS/11/38/28864//British Heart Foundation; //British Heart Foundation

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