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Revista Colombiana de Cardiología

Print version ISSN 0120-5633

Abstract

ALEJANDRO ARROYAVE, Jorge et al. Ablation of tachycardia by intraatrial reentry in patient with Fontan circulation. Rev. Colomb. Cardiol. [online]. 2016, vol.23, n.2, pp.153.e1-153.e5. ISSN 0120-5633.  http://dx.doi.org/10.1016/j.rccar.2015.06.002.

Introduction and objectives: Fontan circulation increased long-term risk of developing arrhythmias, with significant impact on morbidity. The medical therapy is ineffective in these arrhythmias and mapping and ablation procedures have had varying results. A patient with Fontan circulation who developed tachycardia by intraauricular reentry is described. Case report: Patient with history of tricuspid atresia and Fontan circulation is assessed by syncope, palpitations and exercise intolerance. A tachycardia by intraauricular reentry was documented, and it was mapped and ablated successfully. Discussion: Multiple complex arrhythmic mechanisms have been described in patients with Fontan circulation. Typically, a macro reentrant that has similarities with atrial flutter develops. The use of technology that allow electroanatomical (three-dimensional) mapping has identified and successfully treated a small number of patients, as presented in this case. Conclusions: Congenital heart diseases treated with Fontan circulation have a significant prevalence of atrial arrhythmias very difficult to treat with medications and conventional technology. Technological developments in three-dimensional mapping and ablation have allowed to know and better understand arrhythmia's mechanisms in this type of circulation and as a result got a definitive control trough ablation.

Keywords : Congenital heart disease in adults; Arrhythmias; Mapping; Ablation.

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