Catheter ablation of atrial tachyarrhythmias in patients with atrioventricular septal defect

Related Experiment Video

Updated: Jul 16, 2025

Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter
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Reduction of Iatrogenic Atrial Septal Defects with an Anterior and Inferior Transseptal Puncture Site when Operating the Cryoballoon Ablation Catheter

Published on: June 15, 2015

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Victor Waldmann1,2,3,4, Francis Bessière5, Kevin Gardey5

  • 1Université Paris Cité, Inserm, PARCC, 56 rue Leblanc, F-75015 Paris, France.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|September 11, 2023
PubMed

Insights

Catheter ablation for atrial tachyarrhythmias in patients with atrioventricular septal defect (AVSD) shows excellent acute success. However, recurrences are common, especially with complex circuits in repeated procedures.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Atrial tachyarrhythmias are prevalent in patients with atrioventricular septal defect (AVSD).
  • Limited data exist on catheter ablation outcomes for this specific patient population.

Purpose of the Study:

  • To elucidate the primary mechanisms of atrial tachyarrhythmias in AVSD patients.
  • To evaluate the efficacy and outcomes of catheter ablation in this cohort.

Main Methods:

  • An observational, multi-center cohort study included 56 AVSD patients undergoing catheter ablation for atrial tachyarrhythmias between 2004 and 2022.
  • Mechanisms of tachyarrhythmias were analyzed, focusing on re-entrant circuits.
  • Outcomes, including acute success and recurrence rates, were assessed during follow-up.

Main Results:

  • The most common mechanism was cavo-annular isthmus-dependent intra-atrial re-entrant tachycardia (IART) in 73.2% of patients.
  • Acute success was achieved in 96.4% with no reported complications.
  • Recurrence occurred in 39.3% of patients over a mean follow-up of 2.8 years, with 1-year freedom from recurrence at 77.5%.

Conclusions:

  • Cavo-annular isthmus circuits are predominant in AVSD patients with atrial tachyarrhythmias.
  • While acute ablation success is high, recurrences are frequent, necessitating further management.
  • Complex mechanisms, including bi-atrial and left-sided tachyarrhythmias, are more common in patients requiring repeat procedures.
Abstract

Keywords:
Atrial arrhythmiaAtrioventricular septal defectCatheter ablationCongenital heart disease

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