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Cardiovascular diseases, which are the leading global cause of death, should increase by 40% by 2030, reaching close to 24 million deaths worldwide. Atrial fibrillation is the most common heart rhythm disorder, ahead of conduction disturbances and ventricular arrhythmias. Studies estimate that 7.6 million people aged>65 years in the European Union had atrial fibrillation in 2016, and this figure is predicted to increase by 89% to 14.4 million by 2060. Recent innovations in cardiac arrhythmia care, such as cardiac device miniaturization and smart devices, might revolutionize the future of patient care. Yet, the level of adoption of these breakthroughs will depend on their acceptability by patients and healthcare professionals, and on the pace of transformation of the French healthcare system (encouraged by "Ma Santé 2022"). In this article, we detail the major trends that could impact patients with heart rhythm disorders and their healthcare professionals by 2030. Eight major trends and their associated effects on patient care and healthcare professionals' practices were discussed: technical evolution of cardiac devices; digitalization of the healthcare system, and telecardiology; the rise of smart devices; the rise of "big data" and artificial intelligence; patient empowerment; evolution of healthcare; healthcare transformation with "Ma Santé 2022"; and new funding models. These "multidimensional" changes give us room in this study to outline two scenarios for the evolution of care of patients with heart rhythm disorders in the near future., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

The population of patients with congenital heart disease (CHD) is continuously increasing, and a significant proportion of these patients will experience arrhythmias because of the underlying congenital heart defect itself or as a consequence of interventional or surgical treatment. Arrhythmias are a leading cause of mortality, morbidity and impaired quality of life in adults with CHD. Arrhythmias may also occur in children with or without CHD. In light of the unique issues, challenges and considerations involved in managing arrhythmias in this growing, ageing and heterogeneous patient population and in children, it appears both timely and essential to critically appraise and synthesize optimal treatment strategies. The introduction of catheter ablation techniques has greatly improved the treatment of cardiac arrhythmias. However, catheter ablation in adults or children with CHD and in children without CHD is more technically demanding, potentially causing various complications, and thus requires a high level of expertise to maximize success rates and minimize complication rates. As French recommendations regarding required technical competence and equipment are lacking in this situation, the Working Group of Pacing and Electrophysiology of the French Society of Cardiology and the Affiliate Group of Paediatric and Adult Congenital Cardiology have decided to produce a common position paper compiled from expert opinions from cardiac electrophysiology and paediatric cardiology. The paper details the features of an interventional cardiac electrophysiology centre that are required for ablation procedures in adults with CHD and in children, the importance of being able to diagnose, monitor and manage complications associated with ablations in these patients and the supplemental hospital-based resources required, such as anaesthesia, surgical back-up, intensive care, haemodynamic assistance and imaging. Lastly, the need for quality evaluations and French registries of ablations in these populations is discussed. The purpose of this consensus statement is therefore to define optimal conditions for the delivery of invasive care regarding ablation of arrhythmias in adults with CHD and in children, and to provide expert and - when possible - evidence-based recommendations on best practice for catheter-based ablation procedures in these specific populations., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Background: Pericicatricial right intra-atrial reentrant tachycardias occur frequently in patients who have undergone surgical correction of an interatrial defect., Aim: To characterize the tachycardia circuits using three-dimensional electroanatomical mapping., Methods: Twelve tachycardias were analysed in 11 patients who had undergone surgical correction of an interatrial defect. Patients were divided into two groups: atrial flutter with typical sawtooth flutter waves in inferior leads, atrial tachycardia with clearly delimited P waves separated by an isoelectric line., Results: Seven tachycardias were classified as atrial flutter; three-dimensional mapping identified a peritricuspid circuit with inferior vena cava-tricuspid annulus isthmus involvement in all cases. All atrial flutters were terminated by linear ablation of this isthmus. Five tachycardias were classified as atrial tachycardia; three-dimensional mapping identified periatriotomy loops. All atrial tachycardias were ablated successfully between two scars or between a scar and an anatomical barrier., Conclusion: Periatriotomy loops were always associated with an atrial tachycardia electrocardiogram pattern. Three-dimensional electroanatomical mapping appeared to be particularly useful for circuit identification and for ablation of these complex arrhythmias.