Behandeling van een intra-atriale 'reentry'-tachycardie door katheterablatie, met als oriëntatie een driedimensionale elektro-anatomische kaart van het activatiepatroon in het atrium

- A 30-year-old man, who had been treated surgically for tricuspid valve atresia as a boy, suffered from recurrent supraventricular tachycardias. These atrial reentry tachycardias are frequent post-operative complications in patients with congenital heart disease. The reentry circuit in these patients often circulates around areas of scar tissue or surgically created barriers such as incision scars and implanted synthetic material. A possible curative treatment of these arrhythmias is radiofrequency catheter ablation, which is aimed at interrupting critical conduction pathways in the reentry circuit. Accurate location of the reentry circuit is, however, mandatory. A new technique, which correlates intracardiac signals with specific sites in the endocardium, so-called ‘electro-anatomical mapping’, allows accurate three-dimensional location and visualization of the borders of the reentry circuit and facilitates catheter ablation of these complex reentrant arrhythmias. In this patient, the ablation procedure resulted in the disappearance of the rhythm disturbances.