Dextro-transposition of the great arteries electrophysiology testing

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]; Keri Shafer, M.D. [4]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [5]

Overview

ACC/AHA recommends electrophysiology testing in some groups of patients with dextro-transposition of the great arteries

(ACC/AHA) recommendations for Electrophysiology Testing Issues in Dextro-Transposition of the Great Arteries [1](DONOT EDIT)

Class I

1. Clinicians should be mindful of the risk of sudden arrhythmic death among adults after atrial baffle repair of d-TGA. These events usually relate to ventricular tachycardia (VT) but may be caused in some cases by rapidly conducted intra-atrial reentrant tachycardia (IART) or progressive atrioventricular (AV) block. (Level of Evidence: B)

2. Consultation with an electrophysiologist who is experienced with CHD is recommended to assist with treatment decisions. (Level of Evidence: B)

3. Pacemaker implantation is recommended for patients with d-TGA with either symptomatic sinus bradycardia or sick sinus syndrome. (Level of Evidence: B)

Class IIa

1. Routine surveillance with history, electrocardiogram (ECG), assessment of RV function, and periodic Holter monitoring can be beneficial as part of routine follow-up. (Level of Evidence: B)

For ACC/AHA Level of evidences and Classes click :ACC AHA Guidelines Classification Scheme

References

  1. Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA; et al. (2008). "ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons". J Am Coll Cardiol. 52 (23): e1–121. doi:10.1016/j.jacc.2008.10.001. PMID 19038677.

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