Management for atrial arrhythmias in adults with complex congenital heart disease.

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Expert Review of Cardiovascular Therapy Pub Date : 2023-07-01 DOI:10.1080/14779072.2023.2219057
Victor Waldmann, Christophe Vô, Stefano Bartoletti, Francis Bessière, Marie Wilkin, Nabil Dib, Nicolas Combes, Paul Khairy
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Abstract

Introduction: The prevalence of congenital heart disease (CHD) is steadily increasing among adults. Atrial arrhythmias are frequent late complications and are associated with substantial morbidity.

Areas covered: We discuss key considerations regarding management strategies for atrial arrhythmias in common forms of CHD and offer future perspectives.

Expert opinion: An appreciation of the types of atrial arrhythmias encountered in patients with diverse forms of CHD, combined with the growing clinical and research experience, appears to be yielding favorable results, whereas little progress has been made on the antiarrhythmic drug front, indications for anticoagulation have considerably evolved. Advances in interventional techniques have propelled catheter ablation to the forefront to treat a variety of atrial arrhythmias in patients with complex CHD. Nevertheless, much work remains to be done to elucidate underlying pathophysiology, triggers, and critical substrates that predispose patients with specific CHD malformations to develop atrial arrhythmias. Future advances could allow for the implementation of individualized, possibly preemptive, approaches to arrhythmia management. With the prevalence of atrial fibrillation on the rise in the aging population with CHD, concerted efforts must be directed toward optimizing patient selection for catheter ablation as well as refining procedural aspects to safely and more effectively improve long-term outcomes.

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成人复杂先天性心脏病房性心律失常的治疗。
成人先天性心脏病(CHD)患病率稳步上升。心房心律失常是常见的晚期并发症,发病率高。涉及领域:我们讨论了常见形式冠心病心房心律失常管理策略的关键考虑因素,并提供了未来的观点。专家意见:对不同形式冠心病患者所遇到的房性心律失常类型的认识,结合日益增长的临床和研究经验,似乎产生了有利的结果,而在抗心律失常药物方面进展甚微,抗凝的适应症已经有了很大的发展。介入技术的进步将导管消融推向了治疗复杂冠心病患者各种心房心律失常的前沿。然而,仍有许多工作要做,以阐明潜在的病理生理、触发因素和关键底物,使特定冠心病畸形患者易发生心房心律失常。未来的进展可能允许实施个体化,可能是先发制人的心律失常管理方法。随着老年冠心病患者心房颤动患病率的上升,必须共同努力优化导管消融患者的选择,并改进手术程序,以安全有效地改善长期预后。
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来源期刊
Expert Review of Cardiovascular Therapy
Expert Review of Cardiovascular Therapy CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
0.00%
发文量
82
期刊介绍: Expert Review of Cardiovascular Therapy (ISSN 1477-9072) provides expert reviews on the clinical applications of new medicines, therapeutic agents and diagnostics in cardiovascular disease. Coverage includes drug therapy, heart disease, vascular disorders, hypertension, cholesterol in cardiovascular disease, heart disease, stroke, heart failure and cardiovascular surgery. The Expert Review format is unique. Each review provides a complete overview of current thinking in a key area of research or clinical practice.
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