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. 2017 Jun;6(2):42-49.
doi: 10.15420/aer.2016:29:3.

Supraventricular Arrhythmias in Patients with Adult Congenital Heart Disease

Carina Blomström Lundqvist  1 , Tatjana S Potpara  2 , Helena Malmborg  1
Affiliations

Supraventricular Arrhythmias in Patients with Adult Congenital Heart Disease

Carina Blomström Lundqvist et al. Arrhythm Electrophysiol Rev. 2017 Jun.

Abstract

An increasing number of patients with congenital heart disease survive to adulthood; such prolonged survival is related to a rapid evolution of successful surgical repairs and modern diagnostic techniques. Despite these improvements, corrective atrial incisions performed at surgery still lead to subsequent myocardial scarring harbouring a potential substrate for macro-reentrant atrial tachycardia. Macroreentrant atrial tachycardias are the most common (75 %) type of supraventricular tachycardia (SVT) in patients with adult congenital heart disease (ACHD). Patients with ACHD, atrial tachycardias and impaired ventricular function - important risk factors for sudden cardiac death (SCD) - have a 2-9 % SCD risk per decade. Moreover, ACHD imposes certain considerations when choosing antiarrhythmic drugs from a safety aspect and also when considering catheter ablation procedures related to the inherent cardiac anatomical barriers and required expertise. Expert recommendations for physicians managing these patients are therefore mandatory. This review summarises current evidence-based developments in the field, focusing on advances in and general recommendations for the management of ACHD, including the recently published recommendations on management of SVT by the European Heart Rhythm Association.

Keywords: Congenital heart disease; accessory pathway; atrial flutter; atrial tachycardia; catheter ablation; sudden cardiac death; supraventricular tachycardia.

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Conflict of interest statement

Disclosure: The authors have no conflicts of interest to declare.

Figures

Figure 1:
Figure 1:. 12-Lead ECGs During Different Types of Supraventricular Tachycardia. Paper Speed 50 mm/s
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