Imperial College London

DrSonyaBabu-Narayan

Faculty of MedicineNational Heart & Lung Institute

Reader in Adult Congenital Heart Disease
 
 
 
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Contact

 

+44 (0)20 7351 8803s.babu-narayan

 
 
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Location

 

NIHR Cardiovascular Biomedical RChelsea WingRoyal Brompton Campus

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Summary

 

Publications

Publication Type
Year
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207 results found

Gatehouse P, Allen JJ, mathew G, Conway M, Jenkins S, Pennell D, Nielles-Vallespin S, Gatehouse P, Babu-Narayan Set al., 2023, Fully-modelled blood-focused variable inversion times for 3D late gadolinium-enhanced imaging, Magnetic Resonance Imaging, Vol: 98, Pages: 44-54, ISSN: 0730-725X

PurposeVariable heart rate during single-cycle inversion-recovery Late Gadolinium-Enhanced (LGE) scanning degrades image quality, which can be mitigated using Variable Inversion Times (VTIs) in real-time response to R-R interval changes. We investigate in vivo and in simulations an extension of a single-cycle VTI method previously applied in 3D LGE imaging, that now fully models the longitudinal magnetisation (fmVTI).MethodsThe VTI and fmVTI methods were used to perform 3D LGE scans for 28 3D LGE patients, with qualitative image quality scores assigned for left atrial wall clarity and total ghosting. Accompanying simulations of numerical phantom images were assessed in terms of ghosting of normal myocardium, blood, and myocardial scar.ResultsThe numerical simulations for fmVTI showed a significant decrease in blood ghosting (VTI: 410 ± 710, fmVTI: 68 ± 40, p < 0.0005) and scar ghosting (VTI: 830 ± 1300, fmVTI: 510 ± 730, p < 0.02). Despite this, there was no significant change in qualitative image quality scores, either for left atrial wall clarity (VTI: 2.0 ± 1.0, fmVTI: 1.8 ± 1.0, p > 0.1) or for total ghosting (VTI: 1.9 ± 1.0, fmVTI: 2.0 ± 1.0, p > 0.7).ConclusionsSimulations indicated reduced ghosting with the fmVTI method, due to reduced Mz variability in the blood signal. However, other sources of phase-encode ghosting and blurring appeared to dominate and obscure this finding in the patient studies available.

Journal article

Krishnathasan K, Dimopoulos K, Duncan N, Ricci P, Kempny A, Rafiq I, Gatzoulis M, Heng EL, Blakey S, Montanaro C, Babu-Narayan S, Francis D, Li W, Constantine Aet al., 2023, Advanced heart failure in ACHD: The Role of renal dysfunction in management and outcomes, European Journal of Preventive Cardiology, ISSN: 2047-4873

Journal article

Thygesen JH, Tomlinson C, Hollings S, Mizani MA, Handy A, Akbari A, Banerjee A, Cooper J, Lai AG, Li K, Mateen BA, Sattar N, Sofat R, Torralbo A, Wu H, Wood A, Sterne JAC, Pagel C, Whiteley WN, Sudlow C, Hemingway H, Denaxas Set al., 2022, COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records, LANCET DIGITAL HEALTH, Vol: 4, Pages: E542-E557

Journal article

Tortigue M, Nield LE, Karakachoff M, McLeod CJ, Belli E, Babu-Narayan SV, Prigent S, Boet A, Conway M, Elder RW, Ladouceur M, Khairy P, Kowalik E, Kalfa DM, Barron DJ, Mussa S, Hiippala A, Temple J, Abadir S, Le Gloan L, Lachaud M, Sanatani S, Thambo J-B, Gronier CG, Amedro P, Vaksmann G, Charbonneau A, Koutbi L, Ovaert C, Houeijeh A, Combes N, Maury P, Duthoit G, Hiel B, Erickson CC, Bonnet C, Van Hare GF, Dina C, Karsenty C, Fournier E, Le Bloa M, Pass RH, Liberman L, Happonen J-M, Perry JC, Romefort B, Benbrik N, Hauet Q, Fraisse A, Gatzoulis MA, Abrams DJ, Dubin AM, Ho SY, Redon R, Bacha EA, Schott J-J, Baruteau A-Eet al., 2022, Familial Recurrence Patterns in Congenitally Corrected Transposition of the Great Arteries: An International Study, CIRCULATION-GENOMIC AND PRECISION MEDICINE, Vol: 15, ISSN: 2574-8300

Journal article

Ghonim S, Babu-Narayan SV, 2022, Reproducibility of CMR in Patients With Cardiac Implantable Electrical Devices REPLY, JACC-CARDIOVASCULAR IMAGING, Vol: 15, Pages: 955-956, ISSN: 1936-878X

Journal article

Ghonim S, Gatzoulis M, Ernst S, Li W, Moon J, Smith G, Heng EL, Keegan J, Ho SY, McCarthy KP, Shore D, Uebing A, Kempny A, Alpendurada F, Dimopoulos K, Pennell DJ, Babu-Narayan Set al., 2022, Predicting survival in repaired tetralogy of Fallot- a lesion specific and personalised approach, JACC: Cardiovascular Imaging, Vol: 15, Pages: 257-268, ISSN: 1876-7591

Objective: We sought to identifyrepaired tetralogy of Fallot (rTOF) patients at high-risk of death and malignant ventricular arrhythmia (VA). Background: To date there is no robust risk stratification scheme to predict outcomes in adults with rTOF. Methods: Consecutive patients were prospectively recruited for late gadolinium enhancement cardiovascular magnetic resonance (LGE CMR) to define right and left ventricular (RV,LV) fibrosisin addition to proven risk markers. Results: The primary end-point was all-cause mortality. Of the 550 patients, (median age 32 years, 56% male), 27 died (mean follow-up 6.4 (±5.8); total 3512 years). Mortality was independently predicted by RVLGE extent, presence of LVLGE, RV ejection fraction (EF) ≤47%, LVEF ≤55%, B-type natriuretic peptide (BNP) ≥127ng/L, peak exercise oxygen uptake (V02) ≤17ml/kg/min, prior sustained atrial arrhythmia and age ≥50 years. The weighted scores for each of the above independent predictors differentiated a high-risk sub-group patients with a 4.4%, annual risk of mortality (AUC 0.87,P<0.001). The secondary end-point (VA), a composite of life-threatening sustained ventricular tachycardia/resuscitated ventricular fibrillation/sudden cardiac death occurred in 29. Weighted scores that included several predictors of mortality and RV outflow tractakinetic length ≥55mm and RVsystolic pressure ≥47mm Hg identified high-risk patients with a 3.7%, annual risk ofVA (AUC 0.79,P<0.001) RVLGE was heavily weighted in both risk scores due to its strong relative prognostic value. Conclusion: We present ascore integrating multiple appropriately weighted risk factors to identify the sub-group of rTOF patients that are at highannual risk of death who may benefit from targeted therapy.

Journal article

Majeed A, Geva T, Sleeper LA, Graf JA, Lu M, Babu-Narayan S, Wald RM, Mulder BJM, Valente AMet al., 2022, Cardiac MRI predictors of good long-term outcomes in patients with repaired TOF, AMERICAN HEART JOURNAL, Vol: 245, Pages: 70-77, ISSN: 0002-8703

Journal article

Krishnathasan K, Constantine A, Kempny A, Rafiq I, Gatzoulis MA, Heng EL, Montanaro C, Babu-Narayan SV, Li W, Dimopoulos Ket al., 2021, Predictors of adverse clinical outcome after hospitalisation for decompensated heart failure in ACHD patients, European Society of Cardiology congress 2021, Publisher: OXFORD UNIV PRESS, Pages: 1854-1854, ISSN: 0195-668X

Conference paper

Ladouceur M, Segura de la Cal T, Gaye B, Valentin E, Ly R, Iserin L, Legendre A, Mousseaux E, Li W, Rafiq I, Kempny A, Barradas-Pires A, Babu-Narayan S, Gatzoulis MA, Dimopoulos Ket al., 2021, Effect of medical treatment on heart failure incidence in patients with a systemic right ventricle, HEART, Vol: 107, Pages: 1384-1389, ISSN: 1355-6037

Journal article

Hatipoglu S, Almogheer B, Mahon C, Houshmand G, Uygur B, Giblin GT, Krupickova S, Baksi AJ, Alpendurada F, Prasad SK, Babu-Narayan SV, Gatzoulis MA, Mohiaddin RH, Pennell DJ, Izgi Cet al., 2021, Clinical Significance of Partial Anomalous Pulmonary Venous Connections (Isolated and Atrial Septal Defect Associated) Determined by Cardiovascular Magnetic Resonance, CIRCULATION-CARDIOVASCULAR IMAGING, Vol: 14, ISSN: 1941-9651

Journal article

Constantine A, Costola G, Bianchi P, Chessa M, Giamberti A, Kempny A, Rafiq I, Babu-Narayan S, Gatzoulis M, Hoschtitzky A, Shore D, Aw T-C, Ranucci M, Dimopoulos Ket al., 2021, Enhanced assessment of perioperative mortality risk in adults with congenital heart disease, Journal of the American College of Cardiology, Vol: 78, Pages: 234-242, ISSN: 0735-1097

BackgroundIn-hospital mortality is a rare, yet feared complication following cardiac surgery in adult congenital heart disease (ACHD). A risk score, developed and validated in ACHD, can be helpful to optimize risk assessment.ObjectivesTo assess the performance of EuroSCORE II components and procedure-related Adult Congenital Heart Surgery (ACHS) score, identify additional risk factors, and develop a novel risk score for predicting in-hospital mortality after ACHD surgery.MethodsWe assessed perioperative survival in patients >16 years undergoing congenital heart surgery in a large tertiary center between 2003 and 2019. A risk variable derived PErioperative ACHd (PEACH) score was calculated for each patient. Internal and external validation of the model was undertaken, including testing in a validation cohort of patients operated in a second European ACHD center. ResultsThe development cohort comprised 1782 procedures performed during the study period. Re-sternotomy was undertaken in 897(50.3%). There were 31(1.7%) in-hospital deaths. The PErioperative ACHd (PEACH) score showed excellent discrimination ability (AUC 0.88, 95%CI:0.83-0.94), and performed better than the ACHS score in our population (ACHS AUC 0.69, 95%CI:0.6-0.78, p=0.0003). A simple 3-tiered risk stratification was formed: PEACH score 0 (in-hospital mortality 0.2%), 1-2 (3.6%), ≥3 (17.2%). In a validation cohort of 975 procedures, the PEACH score retained its discriminative ability (AUC 0.75, 95%CI:0.72-0.77) and was well calibrated (Hosmer Lemishow 2 goodness-of-fit p=0.55). There was agreement in expected and observed perioperative mortality between cohorts.ConclusionsThe PEACH score is a simple, novel peri-operative risk score developed and validated specifically for ACHD patients undergoing cardiac surgery. Condensed abstract:The PEACH score is a simple, novel peri-operative risk score developed and validated specifically for ACHD patients undergoing cardiac surgery. In this study, we assesse

Journal article

Budts W, Miller O, Babu-Narayan S, Li W, Buechel EV, Frigiola A, van den Bosch A, Bonello B, Mertens L, Hussain T, Parish V, Habib G, Edvardsen T, Geva T, Roos-Hesselink JW, Hanseus K, Dos Subira L, Baumgartner H, Gatzoulis M, Di Salvo Get al., 2021, Imaging the adult with simple shunt lesions: position paper from the EACVI and the ESC WG on ACHD. Endorsed by AEPC (Association for European Paediatric and Congenital Cardiology), EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, Vol: 22, Pages: E58-E70, ISSN: 2047-2404

Journal article

Babu-Narayan S, Ray S, 2021, Women in cardiology: no progress in the pace of change, HEART, Vol: 107, Pages: 860-861, ISSN: 1355-6037

Journal article

Baumgartner H, De Backer J, Babu-Narayan S, Budts W, Chessa M, Diller G-P, Iung B, Kluin J, Lang IM, Meijboom F, Moons P, Mulder BJM, Oechslin E, Roos-Hesselink JW, Schwerzmann M, Sondergaard L, Zeppenfeld K, Ernst S, Ladouceur M, Aboyans V, Alexander D, Christodorescu R, Corrado D, D'Alto M, de Groot N, Delgado V, Di Salvo G, Dos Subira L, Eicken A, Fitzsimons D, Frogoudaki AA, Gatzoulis M, Heymans S, Horer J, Houyel L, Jondeau G, Katus HA, Landmesser U, Lewis BS, Lyon A, Mueller CE, Mylotte D, Petersen SE, Sonia Petronio A, Rosenhek R, Shlyakhto E, Simpson IA, Sousa-Uva M, Tobias Torp-Pedersen C, Touyz RM, Van de Bruaene Aet al., 2021, Respaldado por: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Adult Congenital Heart Disease (ISACHD), REVISTA ESPANOLA DE CARDIOLOGIA, Vol: 74, ISSN: 1885-5857

Journal article

Baumgartner H, De Backer J, Babu-Narayan S, Budts W, Chessa M, Diller G-P, Lung B, Kluin J, Lang IM, Meijboom F, Moons P, Mulder BJM, Oechslin E, Roos-Hesselink JW, Schwerzmann M, Sondergaard L, Zeppenfeld Ket al., 2021, 2020 ESC Guidelines for the management of adult congenital heart disease The Task Force for the management of adult congenital heart disease of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Adult Congenital Heart Disease (ISACHD), EUROPEAN HEART JOURNAL, Vol: 42, Pages: 563-645, ISSN: 0195-668X

Journal article

Surkova E, Segura T, Dimopoulos K, Bispo D, Flick C, West C, Babu-Narayan SV, Senior R, Gatzoulis MA, Li Wet al., 2021, Systolic dysfunction of the subpulmonary left ventricle is associated with the severity of heart failure in patients with a systemic right ventricle, International Journal of Cardiology, Vol: 324, Pages: 66-71, ISSN: 0167-5273

BACKGROUND: The study aimed to assess the relation between echocardiographic parameters of subpulmonary left ventricular (LV) size and function, and the severity of heart failure in patients with a systemic right ventricle (SRV). METHODS AND RESULTS: A total of 157 patients (89 post Mustard/Senning operations, 68 with congenitally corrected transposition of great arteries [ccTGA]) were included. The size and function of the SRV and subpulmonary LV were assessed on the most recent echocardiographic exam. Clinical data were collected from the electronic records. The majority (133, 84.7%) were in NYHA functional class 1-2. Median BNP concentration was 79.5[38.3-173.3] ng/l, and 100 (63.7%) patients were receiving heart failure therapy. Both LV and SRV fractional area change (FAC) differed significantly between patients with NYHA class 1-2 vs 3-4 (48[41.5-52.8]% vs 34[28.6-38.6]%, p < 0.0001 and 29.5[23-35]% vs 22[20-27]%, p < 0.0001, respectively), but LV FAC had a higher discriminative power for functional class >2 than SRV FAC (AUC 0.90, p < 0.0001 vs 0.79; p < 0.0001, respectively). A LV FAC cut-off value <39.2% had the highest accuracy in identifying patients with NYHA class 3-4 (sensitivity 83% and specificity 88%). In multivariable logistic regression analysis, LV FAC and SRV FAC independently associated to NYHA class 3-4 (OR 0.80 [95%CI 0.72-0.88], p < 0.0001 and OR 0.85 [95%CI 0.76-0.96], p = 0.007, respectively). CONCLUSIONS: Subpulmonary LV systolic dysfunction is associated with NYHA functional class 3-4 in patients with ccTGA or after Mustard or Senning operation. Careful evaluation of the subpulmonary LV should be a part of the routine assessment of patients with a SRV.

Journal article

Babu-Narayan SV, Budts W, Chessa M, Diller GP, Iung B, Kluin J, Lang IM, Meijboom F, Moons H, Mulder BJM, Oechslin E, Rooshesselink JW, Schwerzmann M, Sondergaard L, Zeppenfeld K, Windecker S, Aboyans V, Baigent C, Collet JH, Dean V, Delgado V, Fitzsimons D, Gale CP, Grobbee DE, Halvorsen S, Hindricks G, Jüni P, Katus HA, Landmesser U, Leclercq C, Lettino M, Lewis BS, Merkely B, Mueller C, Petersen SE, Petronio AS, Richter DJ, Roffi M, Shlyakhto E, Simpson IA, Sousa-Uva M, Touyz RMet al., 2021, Ghidul esc 2020 pentru managementul bolilor cardiovasculare congenitale la adult, Revista Romana de Cardiologie, Vol: 31, Pages: 395-493, ISSN: 1220-658X

Journal article

Crossland DS, Ferguson R, Magee A, Jenkins P, Bulock FA, Parry A, Babu-Narayan S, Carroll A, Daubeney PEF, Simpson Jet al., 2021, Consultant staffing in UK congenital cardiac services: a 10-year survey of leavers and joiners, OPEN HEART, Vol: 8, ISSN: 2053-3624

Journal article

Liu Y, Chen S, Zuhlke L, Babu-Narayan S, Black GC, Choy M-K, Li N, Keavney BDet al., 2020, Global prevalence of congenital heart disease in school-age children: a meta-analysis and systematic review, BMC CARDIOVASCULAR DISORDERS, Vol: 20, ISSN: 1471-2261

Journal article

Majeed A, Geva T, Graf J, Lu M, Babu-Narayan S, Mulder B, Wald R, Sleeper LA, Valente AMet al., 2020, Cardiac MRI Predictors of Good Long-term Outcomes in Patients With Repaired TOF, Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0009-7322

Conference paper

Ricci P, Ostenfeld E, Flick C, West C, Babu-Narayan S, Nihoyannopoulos P, Li Wet al., 2020, Assessment of biventricular function using advanced echocardiography in patients with Ebstein's anomaly pre and post-tricuspid valve surgery, Euroecho 2020, Publisher: OXFORD UNIV PRESS, Pages: 147-147, ISSN: 0195-668X

Conference paper

Fusco E, Uebing A, Scognamiglio G, Guarguagli S, Kempny A, Diller GP, Gatzoulis MA, Babu-Narayan S, Li Wet al., 2020, Long-term follow-up after percutaneous pulmonary valve implantation: sustained clinical benefit with evidence of persistent biventricular reverse remodeling and improved global performance, European-Society-of-Cardiology (ESC) Congress, Publisher: OXFORD UNIV PRESS, Pages: 2198-2198, ISSN: 0195-668X

Conference paper

Meneguzzo G, Costola G, Constantine A, Ministeri M, Rafiq I, Pires A, Kempny A, Babu-Narayan S, Gatzoulis MA, Dimopoulos Ket al., 2020, Peak oxygen uptake on cardio pulmonary exercise testing predicts mortality in adult Fontan patients, ESC Congress 2020, Publisher: OXFORD UNIV PRESS, Pages: 2178-2178, ISSN: 0195-668X

Conference paper

De Santis J, Constantine A, Ministeri M, Kempny A, Rafiq I, Barradas-Pires A, Rybicka J, Babu-Narayan S, Gatzoulis MA, Dimopoulos Ket al., 2020, Strong association between cardio-pulmonary exercise parameters and mortality in adults with transposition of the great arteries and a systemic right ventricle, ESC Congress 2020, Publisher: OXFORD UNIV PRESS, Pages: 2219-2219, ISSN: 0195-668X

Conference paper

Ghonim S, Ernst S, Keegan J, Giannakidis A, Spadotto V, Voges I, Smith G, Boutsikou M, Montanaro C, Wong T, Ho SY, McCarthy K, Shore D, Dimopoulos K, Uebing A, Swan L, Li W, Pennell D, Gatzoulis M, Babu-Narayan Set al., 2020, 3D late gadolinium enhancement cardiovascular magnetic resonance predicts inducibility of ventricular tachycardia in adults with repaired tetralogy of Fallot, Circulation: Arrhythmia and Electrophysiology, Vol: 13, Pages: 1331-1341, ISSN: 1941-3084

Background - Adults with repaired tetralogy of Fallot (rTOF) die prematurely from ventricular tachycardia (VT) and sudden cardiac death. Inducible VT predicts mortality. Ventricular scar, the key substrate for VT, can be non-invasively defined with late gadolinium enhancement (LGE) cardiovascular magnetic resonance (CMR) but whether this relates to inducible VT is unknown.Methods - Sixty-nine consecutive rTOF patients (43 male, mean 40{plus minus}15 years) clinically scheduled for invasive programmed VT-stimulation were prospectively recruited for prior 3D LGE CMR. Ventricular LGE was segmented and merged with reconstructed cardiac chambers and LGE volume measured.Results - VT was induced in 22(31%) patients. Univariable predictors of inducible VT included increased RV LGE (OR 1.15;p=0.001 per cm3), increased non-apical vent LV LGE (OR 1.09;p=0.008 per cm3), older age (OR 1.6;p=0.01 per decile), QRS duration ≥180ms (OR 3.5;p=0.02), history of non-sustained VT (OR 3.5; p=0.02) and previous clinical sustained VT (OR 12.8;p=0.003); only prior sustained VT (OR 8.02;p=0.02) remained independent in bivariable analyses after controlling for RV LGE volume (OR 1.14;p=0.003). An RV LGE volume of 25cm3 had 72% sensitivity and 81% specificity for predicting inducible VT (AUC 0.81;p<0.001). At the extreme cutoffs for 'ruling-out' and 'ruling-in' inducible VT, RV LGE >10cm3 was 100% sensitive and >36cm3 was 100% specific for predicting inducible VT.Conclusions - 3D LGE CMR-defined scar burden is independently associated with inducible VT and may help refine patient selection for programmed VT-stimulation when applied to an at least intermediate clinical risk cohort.

Journal article

Davies R, Babu-Narayan S, 2020, Deep learning in congenital heart disease imaging: hope but not haste, HEART, Vol: 106, Pages: 960-961, ISSN: 1355-6037

Journal article

Naqvi N, Babu-Narayan S, Krupickova S, Muthialu N, Maiya S, Chandershekar P, Cheang MH, Kostolny M, Tsang V, Marek Jet al., 2020, Myocardial Function Following Repair of Anomalous Origin of Left Coronary Artery from the Pulmonary Artery in Children, JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, Vol: 33, Pages: 622-630, ISSN: 0894-7317

Journal article

Fusco F, Shimada E, Scognamiglio G, Senior R, Gatzoulis MA, Babu-Narayan S, Li Wet al., 2020, Restrictive ventricular septal defect resulting in systemic outflow obstruction in adults with Fontan circulation: challenging diagnosis of a serious and potentially fatal complication, JOURNAL OF CARDIOVASCULAR MEDICINE, Vol: 21, Pages: 276-279, ISSN: 1558-2027

Journal article

Martin-Garcia AC, Dimopoulos K, Boutsikou M, Martin-Garcia A, Kempny A, Alonso-Gonzalez R, Swan L, Uebing A, Babu-Narayan SV, Luis Sanchez P, Li W, Shore D, Gatzoulis MAet al., 2020, Tricuspid regurgitation severity after atrial septal defect closure or pulmonic valve replacement, HEART, Vol: 106, Pages: 455-461, ISSN: 1355-6037

Journal article

Cazzoli I, Gunturiz-Beltran C, Guarguagli S, Alonso-Gonzalez R, Babu-Narayan SV, Dimopoulos K, Swan L, Uebing A, Gatzoulis MA, Ernst Set al., 2020, Catheter ablation for patients with end-stage complex congenital heart disease or cardiomyopathy considered for transplantation: Trials and tribulations, International Journal of Cardiology, Vol: 301, Pages: 127-134, ISSN: 0167-5273

IntroductionArrhythmia contributes significantly to morbidity and mortality of patients with congenital heart disease (CHD) or cardiomyopathy (CMP). It also has the potential to worsen symptoms and is particularly detrimental to patients with advanced heart failure awaiting cardiac transplantation. We report our experience using catheter ablation to treat recurrent arrhythmia in patients with CHD or CMP considered for transplantation.MethodsFive consecutive patients (3 female, mean age 47.8 ± 12.8 years) with complex CHD or CMP (tricuspid atresia, mitral atresia, double inlet left ventricle, arrhythmogenic right ventricular cardiomyopathy, left ventricular non-compaction) presented with either atrial (n = 3) or ventricular (n = 2) arrhythmias. All ablations were guided by three-dimensional (3D) electro-anatomical mapping, plus remote magnetic navigation in 3 patients.ResultsPatients underwent a median of 2 ablation procedures for a total number of 26 tachycardias. None of the 5 patients experienced further arrhythmia at a median of 939 days (range 4–1375) from their last ablation. During a median follow up of 31 months (range 1–70), three patients underwent successful transplantation at 1375, 1062 and 321 days following their last ablation. One patient with a Fontan circulation died from hepatic cancer and one from end-stage heart failure despite urgent transplant listing.ConclusionsCatheter ablation is feasible in complex cardiac patients considered for heart transplantation and should be offered for rhythm management and patient optimization until a suitable donor is found.

Journal article

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