Christopher J. McLeod, M.B., Ch.B., Ph.D., cardiac electrophysiologist at Mayo Clinic, discusses atrial arrhythmias as one of the most common symptoms presenting in adult patients with congenital heart disease in the clinical setting. Importantly, these patients do not always present with tachycardia. Tachycardia usually heralds an underlying hemodynamic issue or it is a very slow tachycardia that is typically scar related and re-entrant in nature. These can often fool the clinician and may lead to a decline in the patient’s ventricular function. This element needs a team of experts to look closely at hemodynamics to ensure that the tachycardia does not signify an underlying hemodynamic issue that may need primary treatment.
The re-entrant atrial arrhythmias have enough treatment options now for these patients to be seen in a center which specializes in the treatment of adult congenital heart disease patients with atrial arrhythmias. At Mayo Clinic, our team approach includes the cardiac radiologist, adult congenital cardiologist, electrophysiologist, interventionalist, and a cardiac surgeon to make sure that the overall patient is treated and not just the atrial arrhythmia.