Table 20. Ongoing Management of ACHD
COR
LOE Recommendations
I C-LD Ongoing management with antithrombotic therapy is
recommended in ACHD patients and AT or atrial flutter to align
with recommended antithrombotic therapy for patients with AF.
I C-LD Assessment of associated hemodynamic abnormalities for
potential repair of structural defects is recommended in ACHD
patients as part of therapy for SVT.
IIa B-NR Preoperative catheter ablation or intraoperative surgical ablation
of accessory pathways or AT is reasonable in patients with SVT
who are undergoing surgical repair of Ebstein anomaly.
IIa B-NR Oral beta blockers or sotalol therapy can be useful for prevention
of recurrent AT or atrial flutter in ACHD patients.
IIa B-NR Catheter ablation is reasonable for treatment of recurrent
symptomatic SVT in ACHD patients.
IIa B-NR Surgical ablation of AT or atrial flutter can be effective in ACHD
patients undergoing planned surgical repair.
IIb B-NR Atrial pacing may be reasonable to decrease recurrences of AT or
atrial flutter in ACHD patients and sinus node dysfunction.
IIb B-NR Oral dofetilide may be reasonable for prevention of recurrent AT
or atrial flutter in ACHD patients.
IIb B-NR Amiodarone may be reasonable for prevention of recurrent AT or
atrial flutter in ACHD patients for whom other medications and
catheter ablation are ineffective or contraindicated.
III:
Harm
B-NR Flecainide should not be administered for treatment of SVT in
ACHD patients and significant ventricular dysfunction.
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