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June 27, 2026EP EuropaceOpen Access

RFCA in ACHD results in ~29% atrial tachyarrhythmia recurrence, predicted by left atrial dilatation.

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Population

80 adult congenital heart disease patients undergoing radiofrequency catheter ablation for atrial…

Design

Cohort

Follow-up

median 12.3 months

Key result

In adult congenital heart disease patients undergoing radiofrequency catheter ablation, atrial tachyarrhythmia recurrence occurred in 29% and was predicted by left atrial dilatation (p<0.001).

Authors

GSG SimiGMG MirizziARA Rossi

Discussion

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Overview

Left atrial dilatation signals higher AT recurrence risk; leaves open whether risk-adapted ablation improves outcomes.

Key Points

  • This study aims to identify the predictors of arrhythmic recurrence after radiofrequency catheter ablation in adult congenital heart disease patients.
  • Retrospective analysis of ACHD patients undergoing RFCA for atrial tachyarrhythmias between 2007 to 2025.
  • Evaluation of clinical, electrocardiographic, procedural, therapeutic, and imaging parameters.
  • Follow-up was censored at documented AT recurrence or last available follow-up.
  • Out of 80 patients, 23 (29%) experienced recurrence of atrial tachyarrhythmias during a median follow-up of 12.3 months.
  • Patients with recurrence were older (52.5 vs 42.5 years, p=0.01) and had lower ejection fractions (52.0% vs 58.7%, p=0.002).
  • Significantly lower arrhythmia-free survival was confirmed for patients with left atrial dilatation (χ2 = 14.6, p<0.001).

Study Design

Type

Cohort (n=80)

Multicenter

No

Structured PICO

P
Population
80 adult congenital heart disease patients (mean age 45.6, 50% female) undergoing radiofrequency catheter ablation for atrial tachyarrhythmias, followed for a median of 12.3 months.
E
Exposure
Radiofrequency catheter ablation (RFCA)
O
Outcome
Any documented atrial tachyarrhythmia (AT) during follow-up after the first procedurehard clinical

In adult congenital heart disease patients undergoing ablation for atrial arrhythmias, left atrial dilatation and systemic ventricular dysfunction are strong predictors of recurrence, highlighting the need for comprehensive pre-procedural imaging.

Cite This Study

Simi et al. (2026) conducted a cohort in Adult congenital heart disease with atrial tachyarrhythmias (n=80). Radiofrequency catheter ablation was evaluated on Arrhythmic recurrence (any documented atrial tachyarrhythmia during follow-up). In adult congenital heart disease patients undergoing radiofrequency catheter ablation, atrial tachyarrhythmia recurrence occurred in 29% and was predicted by left atrial dilatation (p<0.001).

synapsesocial.com/papers/6a3f97bb125782b61d865968https://doi.org/10.1093/europace/euag105.1278
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Characteristics of recurrent atrial tachycardia after radiofrequency catheter ablation in patients with congenital heart disease2026
  2. 2Catheter ablation for recurrent atrial arrhythmias after surgical atrial fibrillation ablation: procedural characteristics, safety, and clinical outcomes2026
  3. 3Predictors of outcome after catheter ablation of atypical atrial flutter2026
  4. 4Atrial and Biventricular Dysfunction Persists after Catheter Ablation and is a Factor of Risk for Post-procedure Atrial Fibrillation Recurrence in Patients with Preserved Left Ventricular Ejection Fraction2025
  5. 5Long-term efficacy of catheter ablation for reentrant atrial tachycardia in dextro-transposition of the great arteries patients after atrial switch2026