Overview of supraventricular tachycardias in patients with congenital heart disease

SVTs are highly prevalent in the growing GUCH population, with a broad spectrum of arrhythmia subtypes that vary according to the underlying type of CHD. Due to the limited efficacy of antiarrhythmic drugs, adverse effects, and patient preferences, there is growing interest in ablative therapy as a potential curative treatment modality. Reported procedural success depends on the complexity of the underlying CHD and arrhythmia substrate and varies from 65% to 90%.

Recurrences of tachyarrhythmias after ablative therapy are common and are indicative of progressive cardiomyopathy, but despite repetitive ablative therapy favorable outcomes could be achieved in most patients. The next challenge in CHD patients is ablative therapy of AFib, a growing epidemic in this population. However, in order to develop an effective treatment strategy, the arrhythmogenic substrates underlying AFib in this complex population have yet to be further elucidated.