RFCA of Tachycardias Associated with a cTGA

Introduction: Tachycardias associated with a congenital corrected transposition of the great artery (cTGA) are rare. Methods: To analyze the type and results of RFCA of tachycardias associated with non-operative cTGA. Results: Five patients were identified. Three patients had atrioventricular reciprocating tachycardia (AVRT) and two had atrioventricular nodal reentrant tachycardia (AVNRT). One AVNRT patient had situs inversus (IDD), and the others situs solitus. Two of the 3 AVRT patients had accessory pathways at the posterior septum (PS) of the anatomical tricuspid annulus (aTA) and the other at PS of the anatomical mitral annulus (aMA). Acute success was accomplished and there were no recurrences in any of the patients. One AVNRT patient had the slow/fast type, and the RFCA application was performed around the anterior. His bundle region in the 2nd session. The tachycardia was no longer observed after the 3rd session. The other patient which had a IDD, had slow/fast and slow/slow AVNRT. The RFCA application was delivered to PS of the aMA for the slow/fast AVNRT where a slow pathway potential was recorded to guide the RFCA application and acute success was achieved. However, when the application was delivered to the aTA for the slow/slow AVNRT in which the earliest atrial activation site was used to guide the application, recurrence immediately occurred. Conclusion: The RFCA results were good for AVRT, but they were not good for AVNRT.