Document Detail


Atrial tachycardia during ongoing atrial fibrillation ablation. - EnSite array analysis-.
MedLine Citation:
PMID:  21471672     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial tachycardia (AT) occurring during atrial fibrillation (AF) ablation is sometimes difficult to identify and eliminate. EnSite Array (EA) visualizes beat-to-beat virtual activation of AT. The aim of the present study was to characterize AT occurring during AF ablation during ongoing AF, using EA.
METHODS AND RESULTS: Among 90 patients with AF (paroxysmal, n=67; persistent, n=23) who underwent radiofrequency catheter ablation during ongoing AF, 33 (37%) had 46 ATs that developed during ablation, and 9 (10%) of these patients had 9 ATs that developed before ablation. AT was sustained in 39 and non-sustained in 7. Nineteen ATs resulted from a focal mechanism and 27 from macroreentry. The major AT foci were distributed in the pulmonary vein (n = 8) and left atrial roof (n = 3), and macroreentrant ATs mainly consisted of peri-mitral AT (n = 10), common atrial flutter (n = 10), and roof reentrant AT (n = 3). After EA-guided ablation of AT, 41 ATs in 28 patients (85%) were eventually rendered non-inducible. During 21 ± 8 months of follow-up, 30 of the 33 patients (91%) were free from AF/AT recurrence.
CONCLUSIONS: AT occurred in 37% of the patients during ongoing AF ablation, resulting from a focal or reentrant mechanism in diverse locations. Peri-mitral AT, common atrial flutter, and AT from the pulmonary vein were frequently observed. These ATs were eliminated by EA-guided radiofrequency ablation in most cases.
Authors:
Yasutsugu Nagamoto; Takeshi Tsuchiya; Koji Miyamoto; Takanori Yamaguchi; Naohiko Takahashi
Publication Detail:
Type:  Journal Article     Date:  2011-04-07
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-04-25     Completed Date:  2011-09-29     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1080-9     Citation Subset:  IM    
Affiliation:
First Department of Internal Medicine, Faculty of Medicine, Oita University, Oita, Japan.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / complications*,  therapy*
Catheter Ablation / adverse effects*,  methods
Humans
Pulmonary Veins / physiopathology
Tachycardia / etiology*
Comments/Corrections
Comment In:
Circ J. 2011;75(5):1049-50   [PMID:  21471670 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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