Abstract
In patients with developmental anomalies, rhythm disturbances are often found, which either occur with the defect itself, or are manifested by manifestations of the disease. In case of development of bradyarrhythmias, implantation of a pacemaker is required. With the development of tachycardia, the quality of life increases significantly and the risk of death increases. Frequent use of drug antiarrhythmic therapy leads to the development of more stable paroxysms of tachycardia. At present, the use of interventional electrophysiology has shown the greatest effectiveness in the study in this group of patients.
Transposition of the great arteries (TMA) accounts for 5% of all congenital heart defects. TMA is often accompanied by cardiac arrhythmias, which become more frequent and persistent over time. The most common supraventricular arrhythmias include isthmus-dependent atrial flutter, atrial reciprocal tachycardia, incisional or scar-related, focal atrial tachycardia, and atrioventricular nodal reciprocal tachycardia.
The purpose of this episode is the subsequent clinical course that leads to the development of intra-atrial reciprocal tachycardia in a patient after palliative correction of transposition of the great vessels using a high-density nonfluoroscopic navigation system.
References
- Filippov A.A., Del Nido P.J., Vasilyev N.V. Management of systemic right ventricular failure in patients with congenitally corrected transposition of the great arteries. Circulation. 2016; 134 (17): 1293–302. DOI: 10.1161/CIRCULATIONAHA.116.022106
- Baysa S.J., Olen M., Kanter R.J. Arrhythmias following the Mustard and Senning operations for dextrotransposition of the great arteries: Clinical aspects and catheter ablation. Card. Electrophysiol. Clin. 2017; 9 (2): 255–71. DOI: 10.1016/j.ccep.2017.02.008. Epub 2017 Mar 22.
- Noheria A., Asirvatham S.J., McLeod C.J. Unusual atrioventricular reentry tachycardia in congenitally corrected transposition of great arteries: A novel site for catheter ablation. Circ. Arrhythm. Electrophysiol. 2016; 9 (6): e004120. DOI: 10.1161/CIRCEP.116.004120
- Park S.H., Choi J.Y., Park E.J., Kim H.D., Choi M.J., Choi S.I. et al. A typical case of L-transposition of the great arteries initially presented as complete atrioventricular block in middle-aged man. J. Cardiovasc. Ultrasound. 2015; 23 (1): 36–9. DOI: 10.4250/jcu.2015.23.1.36. Epub 2015 Mar 30.
- Jain V.D., Moghbeli N., Webb G., Srinivas S.K., Elovitz M.A., Paré E. Pregnancy in women with congenital heart disease: the impact of a systemic right ventricle. Congenit. Heart Dis. 2011; 6 (2): 147–56. DOI: 10.1111/j.1747-0803.2011.00497.x. Epub 2011 Mar 21.
- Reddy Y.M., Chinitz L., Mansour M., Bunch T.J., Mahapatra S., Swarup V. et al. Percutaneous left ventricular assist devices in ventricular tachycardia ablation: multicenter experience. Circ. Arrhythm. Electrophysiol. 2014; 7 (2): 244–50. DOI: 10.1161/CIRCEP.113.000548. Epub 2014 Feb 14.
- Lü F., Eckman P.M., Liao K.K., Apostolidou I., John R., Chen T. et al. Catheter ablation of hemodynamically unstable ventricular tachycardia with mechanical circulatory support. Int. J. Cardiol. 2013; 168 (4): 3859–65. DOI: 10.1016/j.ijcard.2013.06.035. Epub 2013 Jul 15.
- Vaidya V.R., Desimone C.V., Madhavan M., NoheriaA., Shahid M., Walters J. et al. Compatibility of electroanatomical mapping systems with a concurrent percutaneous axial flow ventricular assist device. J. Cardiovasc. Electrophysiol. 2014; 25 (7): 781–6. DOI: 10.1111/jce.12437. Epub 2014 Jun 3.
- Adler A.C., Kodavatiganti R. Mechanical support with impella during malignant arrhythmia ablation: A case report on the growing trend in the electrophysiology laboratory. A Case Rep. 2017; 8 (11): 282–5. DOI: 10.1213/XAA.0000000000000490 10.
- Gelatt M., Hamilton R.M., McCrindle B.W., Connely M., Davis A., Harris L. et al. Arrhythmia and mortality after the Mustard procedure: a 30-year singlecenter experience. J. Am. Coll. Cardiol. 1997; 29 (1): 194–201. DOI: 10.1016/s0735-1097(96)00424-x
About the authors
- Grayr A. Avanesyan, Resident; ORCID
- Andrey G. Filatov, Dr. Med. Sci., Head of the Department of X-ray Surgical and Intraoperative Diagnosis and Treatment of Arrhythmias; ORCID
- Sergey V. Gorbachevskiy, Dr. Med. Sci., Professor, Head of the Department of Surgical Treatment of Cardiac Diseases with
Progressive Pulmonary Hypertension; ORCID
- Ibragim A. Temirbulatov, Cardiovascular Surgeon; ORCID
- Aleksey S. Kovalev, Cand. Med. Sci., Researcher; ORCID
