Tricuspid atresia electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Keri Shafer, M.D. [2] Priyamvada Singh, MBBS [3]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [4]

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Electrocardiogram

  • Shown below is an example of an ECG in tricuspid atresia demonstrating tall peaked right atrial P waves more prominent in the right precordial leads and left ventricular hypertrophy.
  • First degree A-V block may be seen

ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease (DO NOT EDIT)[1][2]

Electrophysiology Testing/Pacing Issues in Single-Ventricle Physiology and After Fontan Procedure (DO NOT EDIT)[1][2]

Class I
"1. Arrhythmia management is frequently an issue in patients after the Fontan procedure, and consultation with an electrophysiologist with expertise in CHD is recommended as a vital part of care. (Level of Evidence: C)"
"2. New-onset atrial tachyarrhythmias should prompt a comprehensive noninvasive imaging evaluation to identify associated atrial/baffle thrombus, anatomic abnormalities of the Fontan pathway, or ventricular dysfunction. (Level of Evidence: C)"
"3. Electrophysiological studies in adults with Fontan physiology should be performed at centers with expertise in the management of such patients. (Level of Evidence: C)"
"4. Clinicians must be mindful of the high risk for symptomatic intra-atrial reentrant tachycardia (IART) in adult patients who have undergone the Fontan operation. This arrhythmia can cause serious hemodynamic compromise and contribute to atrial thrombus formation. Treatment is often difficult, and consultation with an electrophysiologist who is experienced with CHD is recommended whenever recurrent IART is detected. (Level of Evidence: C)"

References

  1. 1.0 1.1 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: Executive Summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines for the management of adults with congenital heart disease)". Circulation. 118 (23): 2395–451. doi:10.1161/CIRCULATIONAHA.108.190811. PMID 18997168.
  2. 2.0 2.1 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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