[II-JCKAP1-6] Electrophysiological Characteristics of Tachyarrhythmias and Effects of Catheter Ablation in Patients with Fontan Circulation
キーワード：Catheter ablation, Tachyarrhythmia, Fontan
Introduction: As tachyarrhythmias in congenital heart disease patients rise, catheter ablation's role grows, though it's limited in Fontan patients. This study explores the arrhythmia burden and catheter ablation's effects in these patients.Methods: Patients with Fontan circulation who underwent catheter ablation for tachyarrhythmia were reviewed. We analyzed characteristics of congenital heart disease, tachyarrhythmia mechanisms, cardiac access approaches, and the efficacy and safety of catheter ablation.Results: Twenty patients with Fontan circulation (mean age 22.8years) underwent 30 catheter ablations for tachyarrhythmia. Seven had heterotaxia syndrome (right isomerism in six, left in one). Nine had lateral tunnel Fontan and 11 had extracardiac conduit Fontan. Fontan conduit puncture succeeded in 18 of 19 cases using inferior vena cava (18 patients) and superior vena cava (1 patient) approaches. Tools used included cut stylets in 13 patients, balloons in 10, and snares in 7. Tachyarrhythmias included focal atrial tachycardia (9 cases), intraatrial macroreentrant tachycardia (IART, 6 cases), twin atrioventricular node reciprocating reentrant tachycardia (4 cases), atrioventricular nodal reentrant tachycardia (3 cases), and unknown (2 cases). Catheter ablation had a 73.3% acute success rate (22 of 30 procedures), a 5.3% recurrence rate (1 of 19 patients), and no complications (0 of 30 procedures).Conclusions: Focal atrial tachycardia and IART are the most common tachycardia mechanisms in patients with Fontan circulation. Catheter ablation is effective and safe.