The complexity of CHD appears to have a significant effect on a study but not in others .
Catheter ablation in ASD and persistent left superior vena cava had a high success rate .
Overall , catheter ablation is safe whichever the type of CHD is .
Conclusion Catheter ablation for AF in CHD had modest efficacy that can be increased by subsequent/repeat ablation and it also has an excellent safety profile .
Abstract Background Prevalence of atrial fibrillation ( AF ) in patients with congenital heart disease ( CHD ) is on the rise .
Anti-arrhythmic drugs are usually the first line of treatment in CHD , however , it is often ineffective and poorly tolerated .
We aim ed to perform a systematic review to assess the efficacy and safety of catheter ablation for AF in CHD .
Natural History and Clinical Predictors of Atrial Tachycardia in Adults With Congenital Heart Disease
Background Atrial tachycardias ( ATs ) are a significant source of morbidity in adults with congenital heart disease ( CHD ) . This study evaluates the incidence and clinical predictors of AT in a cohort of patients with CHD . Methods and Results We included 3311 adults ( median age at entry 22.6 years , 50.6 % males ) with CHD ( 49 % simple , 39 % moderate , and 12 % complex ) prospect ively followed up in a tertiary center for 37 607 person-years . Predictors of AT were identified by multivariable Cox regression analysis accounting for left truncation . An external validation was performed in a contemporary cohort of 1432 patients . Overall , 153 ( 4.6 % ) patients presented AT .  AT burden was highest in complex CHD , such as single ventricle ( 22.8 % ) and D-transposition of the great arteries ( 22.1 % ) . Hazard rates of AT across lifetime , age at presentation , and the time lapse between surgery and the first AT episode varied among the most common CHD . Independent risk factors for developing AT were univentricular physiology , previous intracardiac repair , systemic right ventricle , pulmonary hypertension , pulmonary regurgitation , pulmonary atrioventricular valve regurgitation , pulmonary and systemic ventricular dysfunction . At the age of 40 years , AT-free survival in patients with 0 , 1 , 2 , and ≥3 risk factors was 100 % , 94 % , 76 % , and 50 % , respectively . These findings were confirmed in the validation cohort . Conclusions Natural history of AT differed among the most common forms of CHD . Simple clinical parameters , easily obtained by noninvasive means , were independent predictors of AT in adults with CHD . Although risk was negligible in patients without any of these factors , their addition progressively increased AT burden
The complexity of CHD appears to have a significant effect on a study but not in others .
Catheter ablation in ASD and persistent left superior vena cava had a high success rate .
Overall , catheter ablation is safe whichever the type of CHD is .
Conclusion Catheter ablation for AF in CHD had modest efficacy that can be increased by subsequent/repeat ablation and it also has an excellent safety profile .
Abstract Background Prevalence of atrial fibrillation ( AF ) in patients with congenital heart disease ( CHD ) is on the rise .
Anti-arrhythmic drugs are usually the first line of treatment in CHD , however , it is often ineffective and poorly tolerated .
We aim ed to perform a systematic review to assess the efficacy and safety of catheter ablation for AF in CHD .