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. 2025 May 21:ehaf343.
doi: 10.1093/eurheartj/ehaf343. Online ahead of print.

Catheter ablation in congenital heart diseases: a French nationwide study

Victor Waldmann  1   2   3 , Guillaume Duthoit  4 , Jean-Luc Pasquié  5   6 , Laure Champ-Rigot  7 , Mathieu Albertini  1   2 , Frédéric Anselme  8 , Stefano Bartoletti  9 , Damien Bonnet  3 , Charlène Bredy  5 , Sok-Sithikun Bun  10 , Gaël Clerici  11 , Antoine Da Costa  12 , Christian De Chillou  13 , Pascal Defaye  14 , Maxime de Guillebon  15 , Clément Davril  13 , Antoine Delinière  16 , Nicolas Derval  17 , Geoffroy Ditac  16 , Kevin Gardey  16 , Caroline Ghanimé  18 , Jean-Baptiste Gourraud  19 , Sébastien Hascoet  9 , Néfissa Hammache  13 , Roland Henaine  16 , Laurence Iserin  2 , Peggy Jacon  14 , Frédéric Jourda  20 , Clément Karsenty  21 , Linda Koutbi  22 , Gabriel Laurent  18 , Baptiste Maille  22 , Alice Maltret  9 , Jacques Mansourati  23 , Nathan Marimpouy  5 , Raphael Martins  24 , Philippe Maury  21 , Antoine Milhem  25 , Pamela Moceri  10 , Pierre Ollitrault  7 , Pauline Pinon  2 , Olivier Piot  26 , Robin Richard-Vitton  27 , Frédéric Sacher  17 , Frédéric Sebag  28 , Marine Tortigue  16 , Sandrine Venier  14 , Marie Wilkin  22 , Pierre Winum  29 , Eloi Marijon  1   2 , Nicolas Combes  9   27 , Francis Bessière  16   30
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Free article

Catheter ablation in congenital heart diseases: a French nationwide study

Victor Waldmann et al. Eur Heart J. .
Free article

Abstract

Background and aims: Current evidence on catheter ablation for patients with congenital heart disease (CHD) is derived from small, retrospective studies. This study aims to provide insights from a nationwide contemporary registry.

Methods: This prospective study included all CHD patients referred for catheter ablation from 2020 to July 2024 across 28 French centres. The primary outcome was the rate of per-procedural acute success. Secondary outcomes included complications as well as freedom from arrhythmia recurrence.

Results: A total of 1135 consecutive catheter ablation procedures were performed in 998 patients (mean age 46.1 ± 16 years, 55.5% male). The main primary clinical arrhythmias targeted were atrial flutter/tachycardia in 677 (59.6%), atrial fibrillation in 195 (17.2%), ventricular arrhythmia in 188 (16.6%), and atrioventricular reentrant tachycardia in 38 (3.3%), with significant variations in patterns observed based on the underlying substrate. Clinical arrhythmia was successfully ablated in 1071 patients (94.4%). The mean number of arrhythmias targeted per procedure was 1.5 ± 0.7, with overall acute success rates exceeding 90% for all arrhythmias except for ventricular arrhythmias (86.7%). Acute complication occurred in 43 procedures (3.8%), including 1 (0.1%) death. The overall 1- and 2-year recurrence-free rates were 77.3% (95% confidence interval 74.2%-80.4%) and 68.4% (95% confidence interval 64.7%-72.3%), respectively. Significant variations in recurrence rates were noted based on the type of arrhythmia and the underlying CHD.

Conclusions: Catheter ablation in patients with CHD demonstrates highly favourable acute outcomes and a low complication rate. Recurrence rates during follow-up vary depending on the targeted arrhythmia and the underlying CHD. These findings should be considered in the benefit-risk assessment.

Keywords: Catheter ablation; Congenital heart disease; Supraventricular arrhythmia; Ventricular arrhythmia.

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