Ultrahigh ‐density mapping supplemented with global chamber activation identifies noncavotricuspid‐dependent intra‐atrial re‐entry conduction isthmuses in adult congenital heart disease

AbstractObjectiveTo evaluate the role of ultrahigh ‐density mapping for conduction isthmus (CI) characterization in adult congenital heart disease (ACHD).BackgroundCatheter ablation remains suboptimal for ACHD with atypical intra ‐atrial reentrant tachycardias (IART) that can be challenging to define using existing mapping technology.MethodsAn ultrahigh ‐density mapping system was selectively employed over a 1‐year period for procedures involving noncavotricuspid isthmus‐dependent‐IART. A global activation histogram (GAH) was assessed for the ability to predict ablation targets. Procedural characteristics were compared to a group of matched controls.ResultsTwenty patients (mean age 43  ± 15, 70% male) underwent 20 procedures targeting 34 tachycardias during the study period. Diagnoses included single ventricle (8), tetralogy of Fallot (2), left heart obstruction (3), Ebstein's anomaly (2) atrial septal defect (2), Mustard operation (2), and Rasteilli operation (1). Prior cat heter ablation/Maze operation had been performed in 12 (60%). The median time per map was 21 minutes (interquartile range [IQR], 16‐32), representing 14 834 points per map (IQR 9499‐43 191;P 
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research

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Am J Perinatol DOI: 10.1055/s-0040-1712964 Objective Prematurity and low birth weight (LBW) are risk factors for increased morbidity and mortality in infants with congenital heart defects (CHDs). We sought to describe survival, inhospital morbidities, and 2-year neurodevelopmental follow-up in LBW infants with CHD. Study Design We included infants with birth weight (BW)
Source: American Journal of Perinatology - Category: Perinatology & Neonatology Authors: Tags: Original Article Source Type: research
Survivorship into adulthood of patients with congenital heart disease is due to improvements in prenatal detection, novel surgeries, and specialized adult congenital heart disease care. As patients survive further into adulthood, long-term complications of congenital and repaired physiology have been more clearly elucidated. The overall mortality of patients with adult congenital heart disease with heart failure is around 4%. Congenital malformations, palliations, residual defects, and resultant physiology impact the right ventricle. This relationship influences morbidity and mortality. For this discussion, focus on atrial...
Source: Cardiology Clinics - Category: Cardiology Authors: Source Type: research
Abstract For treatment of complex congenital heart disease, computer simulation using a three-dimensional heart model may help to improve outcomes by enabling detailed preoperative evaluations. However, no highly integrated model that accurately reproduces a patient's pathophysiology, which is required for this simulation has been reported. We modelled a case of complex congenital heart disease, double outlet right ventricle with ventricular septal defect and atrial septal defect. From preoperative computed tomography images, finite element meshes of the heart and torso were created, and cell model of cardiac elec...
Source: Annals of Biomedical Engineering - Category: Biomedical Engineering Authors: Tags: Ann Biomed Eng Source Type: research
Abstract This cross-sectional study assessed distribution and pattern of echocardiography confirmed congenital heart disease, among 593 pediatric patients in outpatient departments of a tertiary care hospital in eastern India. Commonest defects were ventricular septal defect (43, 40.7%), atrial septal defect (241, 31.7%), and tetralogy of Fallot (125, 21%). PMID: 32060246 [PubMed - in process]
Source: Indian Pediatrics - Category: Pediatrics Authors: Tags: Indian Pediatr Source Type: research
ri S, Manohar K, Marwah A, Mishra S, Mohanty SR, Murthy KS, Suresh PV, Radhakrishnan S, Rajashekar P, Ramakrishnan S, Rao N, Rao SG, Reddy CH, Sharma R, Shivaprakasha K, Subramanyan R, Kumar RS, Talwar S, Tomar M, Verma S, Raju V, Working group on Management of Congenital Heart Disease in India Abstract JUSTIFICATION: A number of guidelines are available for management of congenital heart diseases from infancy to adult life. However, these guidelines are for patients living in high income countries. Separate guidelines, applicable to Indian children, are required when recommending an intervention for congenital he...
Source: Indian Pediatrics - Category: Pediatrics Authors: Tags: Indian Pediatr Source Type: research
CONCLUSIONS: The prevalence of CHD in China may have ethnic differences. PMID: 32060241 [PubMed - in process]
Source: Indian Pediatrics - Category: Pediatrics Authors: Tags: Indian Pediatr Source Type: research
A former resident texted me this ECG, done for epigastric pain in an 18 year old.  The pain resolved immediately with treatment for acid reflux, and in the clinician's opinion was clearly GI in origin, but he wanted to know what the strange waves in the QRS were:See the unusual notching in II, III, aVF, and V2-V4.I had no idea what they were.  They reminded me of theDelayed Activation Wave associated with circumflex acute MI.See this case: https://hqmeded-ecg.blogspot.com/2018/05/is-there-delayed-activation-wave.html.But they are clearly different from this.I put it on Facebook EKG club and this is the ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
ConclusionSurgery has an important impact on the longitudinal systolic function of RV and the percutaneous closure has the advantage of preserving right ventricular function.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Publication date: January 2020Source: Archives of Cardiovascular Diseases Supplements, Volume 12, Issue 1Author(s): M. Drissa, H. Jamila, H. DrissaBackgroundAtrial septal defect (ASD) is one of the most common causes of congenital heart disease manifested in adulthood and a subgroup of patients may not develop symptoms until late adulthood.Aim of studyThe aim of our study was to describe clinical and likelihood picture of adults over 60 years born with an ASD type II.MethodsWe performed a retrospective analysis of adult's ASD referred to our institution from 2010 through 2018. Clinical, electrocardiographic, echocardiograp...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Children born with congenital heart disease (CHD) are now surviving at extraordinarily high rates; for most, their life expectancy may be comparable to that of the general population. However, despite the great advances in medical and surgical care, many people with CHD experience long-lasting neurodevelopmental difficulties. These include problems with attention and executive function skills, learning challenges, and in some cases, lower-than-normal IQs. Study links congenital heart disease and autism A recent study published in the journal Pediatrics provides compelling evidence that there may also be an association betw...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Children's Health Heart Health Parenting Screening Source Type: blogs
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