Transposition with atrial switch and risk of sudden death: Submitted by Marc G. Cribbs, MD, FACC

Abstract

In a patient with systemic ventricular dysfunction who has undergone atrial switch (Mustard/Senning operation) 1. Consider persistent or recurrent tachyarrhythmia as a potential cause of the ventricular dysfunction; 2. If the QRS duration is prolonged then consider biventricular pacing using a hybrid approach; 3. If the QRS duration is narrow, there is no benefit to CRT and, as long as there is no indication to pace, a S-ICD is the best option; 4. Antiarrhythmic agents other than β-blockers have little benefit in the treatment of nonsustained VT.