Scholarlink

<p>With the growing number of adults with congenital heart disease (ACHD), the incidence of arrhythmias as a&#xa0;late complication is also increasing. Narrow QRS tachycardias are the most common form of supraventricular arrhythmias in this population, typically arising from postoperative scarring, anatomical reconstruction, and altered conduction pathways. The 12-lead surface ECG remains a&#xa0;key tool for mechanism diagnosis, distinguishing between typical and atypical atrial flutter circuits, focal atrial tachycardias, and atrioventricular (AV) reentrant tachycardias, as well as for guiding interventional therapy planning. Following complex atrial surgeries such as Mustard, Senning, Fontan procedures, or biatrial heart transplantation, conventional ECG interpretation reaches its limits: atypical electrical activation, an abnormal heart axis, multiple reentry substrates, and altered P‑wave morphologies complicate classification. In such cases, the combination of ECG findings, detailed knowledge of the individual postoperative anatomy, three-dimensional electroanatomical mapping, and complementary imaging is essential. Catheter ablation in this patient group achieves high acute success rates with acceptable safety, yet remains prone to recurrences. Structured ECG analysis, modern imaging, and treatment in specialized centers are key to improving long-term outcomes and prognosis.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Schmalkomplex-Tachykardien bei Patienten mit angeborenen Herzfehlern und nach herzchirurgischen Eingriffen

  • 期刊论文

  • 发表日期：

    2026年1月19日

查看全文
  • Moneeb Khalaph,
  • Stephan Molatta,
  • Christian Sohns,
  • Philipp Sommer,
  • Mustapha El Hamriti

摘要

With the growing number of adults with congenital heart disease (ACHD), the incidence of arrhythmias as a late complication is also increasing. Narrow QRS tachycardias are the most common form of supraventricular arrhythmias in this population, typically arising from postoperative scarring, anatomical reconstruction, and altered conduction pathways. The 12-lead surface ECG remains a key tool for mechanism diagnosis, distinguishing between typical and atypical atrial flutter circuits, focal atrial tachycardias, and atrioventricular (AV) reentrant tachycardias, as well as for guiding interventional therapy planning. Following complex atrial surgeries such as Mustard, Senning, Fontan procedures, or biatrial heart transplantation, conventional ECG interpretation reaches its limits: atypical electrical activation, an abnormal heart axis, multiple reentry substrates, and altered P‑wave morphologies complicate classification. In such cases, the combination of ECG findings, detailed knowledge of the individual postoperative anatomy, three-dimensional electroanatomical mapping, and complementary imaging is essential. Catheter ablation in this patient group achieves high acute success rates with acceptable safety, yet remains prone to recurrences. Structured ECG analysis, modern imaging, and treatment in specialized centers are key to improving long-term outcomes and prognosis.