The Lead Episode 22: A Discussion of Catheter Ablation of Atrial Fibrillation in Adult Congenital Heart Disease: Procedural Characteristics and Outcomes-Circulation: Arrhythmia and Electrophysiology

Circulation: Arrhythmia and Electrophysiology

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A new study published in Circulation: Arrhythmia and Electrophysiology reports on the outcomes of catheter ablation for atrial fibrillation (AF) in adult patients with congenital heart disease (CHD). The study included 145 patients who underwent 198 ablations between 2000 and 2020. The primary outcomes were AF recurrence following a 3-month blanking period and repeat ablation. The study found that AF ablation is feasible and effective in patients with CHD and reduces symptoms. The recurrence of AF within 12 months of the first ablation was 37%. The study also found that atrial flutters were frequently induced during the ablation procedure and accounted for the majority of recurrences. The risk of a second ablation at 12 months post-first ablation was 11%, and at 24 months, it was 21%. The severity of arrhythmia-related symptoms and the need for antiarrhythmic drug therapy were significantly reduced following ablation. The study concludes that AF ablation is an effective strategy for reducing the burden of AF and improving the quality of life in adult CHD patients. However, larger multicenter studies are needed to evaluate the role of ablation in managing AF, particularly in patients with moderate and complex CHD.

Keywords

Catheter ablation

Atrial fibrillation

Congenital heart disease

AF recurrence

Repeat ablation

Atrial flutters

Arrhythmia-related symptoms

Antiarrhythmic drug therapy

Burden of AF

Quality of life