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Europace Advance Access published online on August 17, 2006
Europace, doi:10.1093/europace/eul096
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© The European Society of Cardiology 2006. All rights reserved
Received February 9, 2006
Accepted June 9, 2006

Article

Successful ablation of atrioventricular nodal reentry tachycardia following the atriopulmonary Fontan procedure

Dominic J. Abrams 1, Mark J. Earley 1, Simon C. Sporton 1, and Richard J. Schilling 1 *

1 Department of Cardiac Electrophysiology, St. Bartholomew's Hospital, 60, Dominion House, Bartholomew Close, West Smithfield, London EC1A 7BE, UK

* To whom correspondence should be addressed.
Richard J. Schilling, E-mail: r.schilling{at}qmul.ac.uk


  Abstract

Arrhythmia is a prevalent complication of the atriopulmonary Fontan procedure, most commonly macro-reentrant tachycardia within the right atrium as a consequence of long-term morphological and haemodynamic changes coupled with surgical intervention. We describe a patient with a long history of supraventricular arrhythmia following the atriopulmonary Fontan procedure identified as atrioventricular nodal reentry tachycardia at electrophysiological assessment. Despite anatomical and technical difficulties related to right atrial morphological changes and loss of the tricuspid annulus with its associated anatomical landmarks, the arrhythmia was successfully ablated using a combined antegrade and retrograde mapping approach.

Keywords: Atrioventricular nodal reentry tachycardia; Fontan; Tricuspid atresia.
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