Abstract
BACKGROUND: Patients with congenitally corrected transposition of the great arteries (cc-TGA) are predisposed to supraventricular tachycardias; however, data regarding the outcomes of catheter ablation (CA) remain limited. OBJECTIVE: This study aimed to assess the clinical impact of CA for supraventricular tachycardias in patients with cc-TGA. METHODS: This retrospective, single-center cohort study evaluated 29 of 112 cc-TGA patients (26%) who underwent CA. Patients were stratified into 3 groups based on surgical history: anatomical repair (n = 10/43, 23%), physiologic repair (n = 14/32, 44%), and no prior surgery (n = 5/37, 14%). Clinical characteristics and procedural outcomes were analyzed. RESULTS: Of the 29 patients who underwent CA, 10 belonged to the anatomical repair group, 14 to the physiologic repair group, and 5 to the non-surgical group. Median age at ablation was significantly lower in the anatomical repair group (25.6 years), compared with physiologic (40.6 years, P = .005) and non-surgical patients (43.8 years, P = .01). The arrhythmia types included intra-atrial reentrant tachycardia (n = 20), focal atrial tachycardia (n = 3), paroxysmal supraventricular tachycardia (n = 2), and atrial fibrillation (n = 6). Cavomitral isthmus ablation was frequently required across all groups. Over a median follow-up of 5.6 years, 3 patients required repeat ablation; all experienced new arrhythmia mechanisms distinct from the index procedure. CONCLUSION: Supraventricular tachycardia patterns varied by surgical background, but cavomitral isthmus ablation was commonly indicated. CA is a key therapeutic strategy in the long-term rhythm management of cc-TGA patients.