New developments in catheter ablation for patients with congenital heart disease.
Details
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State: Public
Version: Final published version
License: All rights reserved
UNIL restricted access
State: Public
Version: Final published version
License: All rights reserved
Serval ID
serval:BIB_95AC4778EFC3
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
New developments in catheter ablation for patients with congenital heart disease.
Journal
Expert review of cardiovascular therapy
ISSN
1744-8344 (Electronic)
ISSN-L
1477-9072
Publication state
Published
Issued date
01/2021
Peer-reviewed
Oui
Volume
19
Number
1
Pages
15-26
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Publication Status: ppublish
Abstract
Introduction: There are numerous challenges to catheter ablation in patients with congenital heart disease (CHD), including access to cardiac chambers, distorted anatomies, displaced conduction systems, multiple and/or complex arrhythmia substrates, and excessively thickened walls, or interposed material. Areas covered: Herein, we review recent developments in catheter ablation strategies for patients with CHD that are helpful in addressing these challenges. Expert opinion: Remote magnetic navigation overcomes many challenges associated with vascular obstructions, chamber access, and catheter contact. Patients with CHD may benefit from a range of ablation catheter technologies, including irrigated-tip and contact-force radiofrequency ablation and focal and balloon cryoablation. High-density mapping, along with advances in multipolar catheters and interpolation algorithms, is contributing to new mechanistic insights into complex arrhythmias. Ripple mapping allows the activation wave front to be tracked visually without prior assignment of local activation times or window of interest, and without interpolations of unmapped regions. There is growing interest in measuring conduction velocities to identify arrhythmogenic substrates. Noninvasive mapping with a multielectrode-embedded vest allows prolonged bedside monitoring, which is of particular interest in those with non-sustained or multiple arrhythmias. Further studies are required to assess the role of radiofrequency needle catheters and stereotactic radiotherapy in patients with CHD.
Keywords
Arrhythmias, Cardiac/surgery, Catheter Ablation/adverse effects, Catheter Ablation/methods, Cryosurgery/methods, Heart Defects, Congenital/surgery, Humans, Treatment Outcome, Congenital heart disease, arrhythmia, catheter ablation, high-density mapping, remote magnetic navigation
Pubmed
Web of science
Create date
22/11/2020 11:46
Last modification date
09/01/2024 7:15