Tricuspid atresia electrocardiogram

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Keri Shafer, M.D. [2] Priyamvada Singh, MBBS [[3]]; Assistant Editor-In-Chief: Kristin Feeney, B.S. [[4]]

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Electrocardiogram

• Shown below is an example of an ECG in tricuspid atresia demonstrating tall peaked right atrial P waves more prominent in the right precordial leads and left ventricular hypertrophy.
• First degree A-V block may be seen

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ACC/AHA 2008 Guidelines - Recommendations for Electrophysiology Testing/Pacing Issues in Single-Ventricle Physiology and after Fontan Procedure - Tricuspid atresia(DO NOT EDIT)

Class I

"1.Arrhythmia management is frequently an issue in patients after the Fontan procedure, and consultation with an electrophysiologist with expertise in CHD is recommended as a vital part of care.(Level of Evidence: C) "

"2.New-onset atrial tachyarrhythmias should prompt a comprehensive noninvasive imaging evaluation to identify associated atrial/baffle thrombus, anatomic abnormalities of the Fontan pathway, or ventricular dysfunction.(Level of Evidence: C) "

"3.Electrophysiological studies in adults with Fontan physiology should be performed at centers with expertise in the management of such patients.(Level of Evidence: C) "

"4.Clinicians must be mindful of the high risk for symptomatic intra-atrial reentrant tachycardia (IART) in adult patients who have undergone the Fontan operation. This arrhythmia can cause serious hemodynamic compromise and contribute to atrial thrombus formation. Treatment is often difficult, and consultation with an electrophysiologist who is experienced with CHD is recommended whenever recurrent IART is detected.(Level of Evidence: C) "