{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:45:06Z","timestamp":1762508706689,"version":"3.37.3"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,3,7]],"date-time":"2022-03-07T00:00:00Z","timestamp":1646611200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ablation of atrial arrhythmias in patients with congenital heart disease (CHD) has markedly improved with advanced mapping systems. However, recurrence rates remain high. The linear ablation strategy is not uncommonly practiced necessitating prolonged ablation times. We report the outcomes of adopting a strategy of minimal, cluster delivery of radiofrequency (RF) energy at critical substrates identified by ultrahigh\u2010definition mapping for atrial arrhythmias in patients with CHD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Non\u2010cavotricuspid isthmus (non\u2010CTI) atrial tachycardias were ablated with a targeted ablation cluster technique (TACT) using an ultrahigh\u2010density mapping system combined with multielectrode monitoring and endpoint determination in preference to linear ablation. The arrhythmia substrates, RF times, and acute\u2010 and medium\u2010term success rates were studied.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010eight tachycardias were mapped and ablated in 42 procedures: 34 non\u2010CTIs and 24 CTIs. A targeted ablation cluster was performed for non\u2010CTI tachycardias, with a median ablation time of 3.1\u2009min. In 53% of non\u2010CTI tachycardias, arrhythmia termination was achieved with \u22642 RF applications. After a mean follow\u2010up of 23.6 months, 27 (80%) patients were free of recurrent atrial arrhythmias. One of 34 targeted non\u2010CTI tachycardia recurred, with a final success rate of 91%. Linear ablation was performed for CTI flutters with a median ablation time of 6.8\u2009min (vs. non\u2010CTIs, <jats:italic>p<\/jats:italic>\u2009=\u2009.006). Three of 21 tachycardias recurred due to reconnection of the ablation line but the final success rate was 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The TACT approach for non\u2010CTI atrial arrhythmias in congenital patients as guided by the\u00a0ultrahigh\u2010density mapping is an effective method with short ablation times and excellent medium\u2010term outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15425","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T04:23:50Z","timestamp":1646022230000},"page":"932-942","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Targeted cluster ablation of non\u2010CTI\u2010dependent atrial arrhythmias in congenital heart disease using ultrahigh\u2010definition mapping"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0463-9480","authenticated-orcid":false,"given":"Anna","family":"Kefala","sequence":"first","affiliation":[{"name":"Department of Cardiology University Hospital Southampton Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Claridge","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Southampton Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-4443","authenticated-orcid":false,"given":"Pradeep","family":"Wijayagoonawardana","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Southampton Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shankar","family":"Sadagopan","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Southampton Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waqas","family":"Ullah","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Southampton Southampton UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur","family":"Yue","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital Southampton Southampton 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