Ablation of atrial tachyarrhythmias late after surgical correction of tetralogy of Fallot: long-term follow-up.
BACKGROUND
After the surgical correction of tetralogy of Fallot, surgical scars and natural obstacles form pathways capable of supporting an atrial tachyarrhythmia (AT). Radiofrequency (RF) ablation is effective, although the few studies published on this topic had relatively short follow-up periods.


AIM
The aims of the study were to evaluate the acute and long-term effects of RF ablation of AT and examine the charac-teristics of arrhythmia recurrence.


METHODS
Tetralogy of Fallot patients (n = 16, age 44.7 ± 10.7 years) referred for ablation of ATs, appearing 25.7 ± 9.6 years after repair, were studied.


RESULTS
Twenty-five ATs were ablated, including 16 cavo-tricuspid isthmus atrial flutters (CTI-AFLs) and nine intraatrial reentrant tachycardia (IART). In one patient with paroxysmal atrial fibrillation (PAF), pulmonary vein isolation was also performed. Ten patients had permanent, and six had paroxysmal arrhythmia prior to the first ablation. Four patients had PAF. Regardless of the type of first ablated arrhythmia, all 16 patients required CTI-AFL ablation. The effectiveness of the first RF ablation reached 88%. The acute efficacy of RF ablation was 100% for CTI-AFL and 78% for IART. Long-term follow-up was possible in 15 out of 16 patients (mean follow-up 68.8 ± 36.6 months). Four patients were free of sustained arrhythmia, nine (60%) had AF. After the last RF ablation, an episode suggestive of CTI-AFL/IART was documented only in one patient.


CONCLUSIONS
Ablation of CTI-AFL/IART in tetralogy of Fallot patients is safe and effective. AF was observed in most patients during the long-term follow-up. Regardless of the type of the first ablated arrhythmia, all patients required CTI-AFL ablation.
['Orczykowski|Michał|M|', 'Borowiec|Karolina|K|', 'Biernacka|Elżbieta|E|', 'Bodalski|Robert|R|', 'Urbanek|Piotr|P|', 'Derejko|Paweł|P|', 'Kodziszewska|Katarzyna|K|', 'Woźniak|Olgierd|O|', 'Fronczak|Aneta|A|', 'Marcinkiewicz|Kamil|K|', 'Guzek|Krystyna|K|', 'Fil|Agnieszka|A|', 'Warmiński|Grzegorz|G|', 'Hoffman|Piotr|P|', 'Bilińska|Maria|M|', 'Szumowski|Łukasz|Ł|']
D000328:Adult D000368:Aged D001282:Atrial Flutter D006348:Cardiac Surgical Procedures D017115:Catheter Ablation D005260:Female D005500:Follow-Up Studies D006801:Humans D008297:Male D008875:Middle Aged D012008:Recurrence D013610:Tachycardia D013771:Tetralogy of Fallot D016896:Treatment Outcome D055815:Young Adult
tetralogy of Fallot arrhythmia atrial flutter radiofrequency ablation