71. Mapping and Imaging of Supraventricular Arrhythmias in Adult Complex Congenital Heart Disease

  1. Mohammad Shenasa MD2,
  2. Gerhard Hindricks MD3,
  3. Martin Borggrefe MD4,
  4. Günter Breithardt MD5 and
  5. Mark E. Josephson MD6
  1. Paul Khairy

Published Online: 18 DEC 2012

DOI: 10.1002/9781118481585.ch71

Cardiac Mapping, Fourth Edition

Cardiac Mapping, Fourth Edition

How to Cite

Khairy, P. (2013) Mapping and Imaging of Supraventricular Arrhythmias in Adult Complex Congenital Heart Disease, in Cardiac Mapping, Fourth Edition (eds M. Shenasa, G. Hindricks, M. Borggrefe, G. Breithardt and M. E. Josephson), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781118481585.ch71

Editor Information

  1. 2

    Attending Physician, Department of Cardiovascular Services, O'Connor Hospital, Heart & Rhythm Medical Group, San Jose, California, USA

  2. 3

    Professor of Medicine (Cardiology), University Leipzig, Heart Center, Director, Department of Electrophysiology, Leipzig, Germany

  3. 4

    Professor of Medicine (Cardiology), Head, Department of Cardiology, Angiology and Pneumology, University Medical Center, Mannheim Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany

  4. 5

    Professor Emeritus of Medicine and Cardiology, Department of Cardiology and Angiology, Hospital of the University of Münster, Münster, Germany

  5. 6

    Chief, Cardiovascular Medicine Division, Director, Harvard-Thorndike Electrophysiology Institute and Arrhythmia Service, Beth Israel Deaconess Medical Center, Herman C. Dana Professor of Medicine, Harvard Medical School, Boston, Massachusetts, USA

Author Information

  1. Adult Congenital Heart Center and Electrophysiology Service, Montreal Heart Institute, University of Montreal, Montreal, QC, Canada

Publication History

  1. Published Online: 18 DEC 2012
  2. Published Print: 10 JAN 2013

ISBN Information

Print ISBN: 9780470670460

Online ISBN: 9781118481585

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Keywords:

  • congenital heart disease;
  • catheter ablation;
  • electroanatomical mapping;
  • imaging

Summary

The vast majority of infants born with congenital heart disease now survive well into adulthood. Improved longevity has exposed patients to alternative sources of morbidity and mortality, of which arrhythmias figure prominently. While in some instances, supraventricular arrhythmias are intrinsic to the congenital heart defect, they predominantly arise as a consequence of corrective surgery where patches, baffles, conduits and suture lines intermix with fibrosis and hypertrophy to create the substrate for focal and macroreentrant tachycardias. An improved understanding of arrhythmia substrates has paralleled technological advances in imaging, three-dimensional mapping, and lesion creation such that catheter ablation has become an indispensable therapeutic modality for supraventricular arrhythmias in congenital heart disease. However, such advances are not a substitute for a clear understanding of anatomical complexities, potential variations in the location and susceptibility to injury of the sinus and atrioventricular nodes, challenges related to vascular and intra-cardiac access, and anticipated arrhythmia substrates. It is the purpose of this chapter to focus on imaging, mapping, and ablation of supraventricular arrhythmias in various common forms of congenital heart disease.