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3D Electroanatomical Mapping for Complex Atrial Arrhythmias in Adult Congenital Heart Disease-A Single Center

Nili Schamroth Pravda1,2, Ofir Brem3, Alon Barsheshet2,4

  • 1Adult Congenital Heart Disease Service, Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.

Pacing and Clinical Electrophysiology : PACE
|July 17, 2025
PubMed

Insights

High-density electro-anatomical mapping effectively treats complex atrial arrhythmias in Adult Congenital Heart Disease (ACHD) patients. This safe and feasible approach demonstrated an acceptable success rate for these challenging cases.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Congenital Heart Disease

Background:

  • Adult Congenital Heart Disease (ACHD) patients frequently experience complex and atypical atrial arrhythmias.
  • Traditional treatments are often insufficient due to the unique anatomy of ACHD patients.
  • 3D electro-anatomical mapping systems are crucial for identifying and ablating arrhythmia sources.

Purpose of the Study:

  • To evaluate the safety, feasibility, and effectiveness of high-density 3D electro-anatomical mapping for treating atrial arrhythmias in ACHD patients.
  • To assess procedural success and recurrence rates in this specific patient population.

Main Methods:

  • Retrospective analysis of 16 ACHD patients undergoing 21 electro-anatomical mapping and ablation procedures.
  • Utilized the high-density Rhythmia mapping system (Boston Scientific).
  • Defined procedural success as non-inducibility of sustained or clinical arrhythmia post-ablation.

Main Results:

  • The cohort included 16 patients (87% female, average age 43.5 years) with diverse ACHD diagnoses.
  • Procedures achieved 66.6% success, 23.8% partial success, and 9.5% failure, with no major adverse events.
  • At a mean follow-up of 15.3 months, 44% experienced arrhythmia recurrence, leading to re-do procedures in four cases.

Conclusions:

  • High-resolution 3D electro-anatomical mapping is a safe, feasible, and effective tool for managing complex atrial arrhythmias in ACHD.
  • The technique aids in identifying and treating atypical arrhythmogenic substrates in patients with anomalous cardiac anatomy.
  • Mapping-assisted ablation offers an acceptable success rate for this challenging patient group.
Abstract

Keywords:
ablationadult congenital heart diseaseatrial arrhythmiaselectrophysiologyelectro‐anatomical mapping

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