Technological Advances in Arrhythmia Management Applied to Adults with Congenital Heart Disease

Publication date: Available online 5 October 2019Source: Canadian Journal of CardiologyAuthor(s): Blandine Mondésert, Krishnakumar Nair, Christopher J. McLeod, Paul KhairyAbstractArrhythmias are a leading cause of morbidity in adults with congenital heart disease (CHD). Numerous challenges to managing arrhythmias include vascular access issues, intracardiac shunts, unconventional locations of the conduction system, and anatomical complexities. Technological advances are improving our ability to diagnose and treat arrhythmias. Implantable loop recorders and various technologies developed for consumers to record electrocardiographic tracings by means of smartphone applications, watches, and dedicated portable devices are expanding our armamentarium of diagnostic tools. Remote magnetic-guided catheter ablation is enhancing access to otherwise difficult to reach arrhythmia substrates. Cryoablation allows perinodal arrhythmias to be safely treated in patients with displaced or difficult to predict locations of the atrioventricular conduction system. Interventions that minimize radiation exposure to near zero levels are gaining interest and pulmonary vein isolation procedures to treat atrial fibrillation are increasingly performed. Cardiac implantable electronic devices compatible with magnetic resonance imaging have become the norm. Subcutaneous defibrillators and leadless pacemakers are providing effective solutions to patients in whom transvenous leads are contraindicated or no...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research