Outcomes of Radiofrequency Catheter Ablation in Congenital Heart Disease: A Retrospective Analysis of Arrhythmia Subtypes and Recurrence Rates

Abstract

Objectives: Arrhythmias in congenital heart disease (CHD) patients are increasingly recognized, with radiofrequency (RF) catheter ablation becoming a more frequent treatment option. However, published data on outcomes remain scarce. This study aimed to analyze the types of arrhythmias in CHD patients undergoing RF catheter ablation and assess its effectiveness and safety. Methodology: This retrospective observational study collected data from January 2019 to December 2023, with a 6-month post-procedure follow-up. Underlying disease and arrhythmia types were diagnosed using ECG and echocardiography. All patients underwent RF catheter ablation. Results: A total of 50 procedures were performed in 48 patients. Isolated Ebstein’s anomaly was the most frequently encountered CHD (n = 19, 40.00%). The most common arrhythmia was atrioventricular reentry tachycardia (AVRT) (n = 26, 52.00%). Six patients (13%) had previously undergone ablation. The mean acute success rate was 80%, comparable to prior studies. Complications occurred in three patients (6%), including two major complications (cardiac tamponade and ventricular fibrillation), both successfully managed. The recurrence rate over 6 months was 33%, with 52% of patients (n = 26) remaining arrhythmia-free. Multiple regression analysis identified left ventricular ejection fraction (EF) as the only significant predictor of recurrence, with lower EF associated with increased recurrence risk. Kaplan-Meier analysis demonstrated the highest incidence of recurrence at 6 months (0.46, 95% CI; p = 0.004). Conclusion: Arrhythmias in CHD patients are becoming more prevalent. RF ablation demonstrates high efficacy and low complication rates, making it a viable early alternative to medical therapy, particularly in young patients at risk of long-term antiarrhythmic side effects. 3D electroanatomical mapping is essential for complex cases.