Saturday, March 7, 2026
Read our new publication on pre-operative conduction system mapping!
by our PhD student Nawin Ramdat Misier, Nicholas Andersen, Dorothea Werner, Scott J. Weinreb, Matthew S. Lemler, Munes Fares, Kavita Sharma, Matthew D. Kenny, Natasja MS de Groot and Hoang Nguyen
Contact person
Prof. dr. Natasja de Groot
translationele.elektrofysiologie@erasmusmc.nl
Congenital Heart Surgery & Electrophysiology
Avoiding injury to the atrioventricular conduction system remains one of the key challenges during complex congenital heart surgery. In a recently published case report in JTCVS Techniques, a novel preoperative transcatheter conduction system mapping strategy was described to guide surgical planning and reduce the risk of postoperative conduction disturbances.
In this case, a 10-year-old patient with {S, L, L}-transposition of the great arteries, a ventricular septal defect, and pulmonary stenosis underwent high-density electroanatomic mapping integrated with MRI and transesophageal echocardiography before surgery. This approach allowed precise localization of the His bundle and bundle branches, demonstrating that the conduction pathway was remote from the surgical field.
This preoperative insight enabled a safe physiological repair with preserved atrioventricular conduction postoperatively.
Key takeaway:
Preoperative conduction system mapping may not only guide the technical execution of biventricular repair but could also influence the broader decision between biventricular repair versus single-ventricle palliation in complex congenital heart disease.
Exciting to see how the integration of advanced imaging and electrophysiological mapping can further personalize congenital heart surgery and improve outcomes.
