Abstract
Background: We aimed to clarify the issues of the percutaneous transconduit puncture and the results of catheter ablation of supraventricular tachycardia with an extracardiac total cavopulmonary connection （eTCPC）
Method: Four cases of tachyarrhythmia after the eTCPC undergoing catheter ablation via the transconduit approach were included in this study. We analyzed patient characteristics, issues associated with the transconduit puncture and catheter ablation, and the results.
Results: The age at the time of catheter ablation was from 13 to 19. Three had a right isomerism heart and single ventricle and the other had a double outlet of the right ventricle. The targeted arrhythmias were atrioventricular reciprocating tachycardia via the accessory pathway （AVRT via AP） in one, AVRT via AP and a tachycardia involving twin atrioventricular nodes in one, intra-atrial reentrant tachycardia in one, and paroxysmal junctional tachycardia in one. All patients were successfully ablated via the transconduit approach. The interval from the eTCPC to the catheter ablation was three to twelve years. It was difficult to puncture the straight shaped conduit and ringed artificial conduit. We needed to devise a way to advance the long sheath into the atrium and had a hard time treating complicated arrhythmias, such as intra-atrial reentrant tachycardia and junctional tachycardia.
Conclusion: We experienced four cases of catheter ablation for tachyarrhythmia using the transconduit approach. This technique will be a useful technique for treating increasing tachycardias after an eTCPC. It is important to clarify the issues and establish the safety of this technique in the future.
