ESOPHAGEAL SIGNALS AS REFERENCE GUIDE FOR ABLATIONS IN
CONGENITAL HEART DISEASES
Despite technological advances in the field of catheter ablation and
mapping system, there can be some limitations and challenges especially
in congenital heart disease due to complexity of anatomy. In complex
cardiac anatomy such as heterotaxia syndromes, chambers of heart, great
vessels and structures such as coronary sinus may pose problems as they
are not located where they used to be [1]. Vascular access is
another challenge beside this complex anatomy, and arrhythmia
mechanisms. During electrophysiological studies and ablation procedures
reference signal keeps its importance in respect to recent developments
of technology of mapping systems. A stable reference signal is mandatory
in all cases. In such cases due to limitations of vascular access and
size of the pediatric patients, additional catheter for intracardiac
electrograms cannot be placed in atria stable position. Due to stability
and gaining both atrium and ventricular signals, coronary sinus is the
most convenient place for reference catheters. The quadripolar catheters
used for the
transesophageal
electrophysiological study is an alternative in such cases. Since the
esophagus is in an anatomical position close to the left atrium, signals
acquired from esophagus have both atrial and ventricular signals. In
addition to acquiring stable signals from atria and ventricle, it can
also be used to stimulate the atria [2, 3].
To aim of this article is to report the effectiveness of transesophageal
electrode as a reference catheter in patients with limited vascular
access and complex congenital heart disease during ablation procedures.