Document Detail

Atrial macroreentry tachycardia in patients without obvious structural heart disease or previous cardiac surgical or catheter intervention: characterization of arrhythmogenic substrates, reentry circuits, and results of catheter ablation.
MedLine Citation:
PMID:  17537207     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Atrial macroreentry tachycardia (AMRT) in patients without obvious structural heart disease or previous surgical or catheter intervention has not been characterized in detail. METHODS AND RESULTS: Electroanatomical mapping and ablation of right or left AMRT were performed in 33 patients. Right atrial central conduction obstacle was formed by an electrically silent area (ESA) in 15 (68%) patients and by a line of double potentials (DPs) in seven (32%) patients. Left atrial ESAs were found in all 11 patients with the left AMRT. Reentry circuit was reconstructed in 19 (86%) patients with right AMRT and seven (64%) patients with left AMRT. Of the ESA-related right AMRT, eight (50%) were double-loop reentry circuits utilizing a narrow critical isthmus within the ESA and eight (50%) were single-loop reentry circuits with a critical isthmus bounded by ESA and either ostium of the vena cava. Single-loop DP-related AMRTs had the critical isthmus between the DP line and the ostium of the inferior vena cava (IVC). Left AMRTs included a variety of single-, double-, or triple-loop reentry circuits and their critical isthmuses. During the 37 +/- 15 month follow-up, atrial tachyarrhythmia-free clinical outcome was achieved in 21 (95%) patients (18 patients, 82%, without antiarrhythmic drugs) with the right AMRT and in nine (82%) patients (six patients, 55%, without antiarrhythmic drugs) with the left AMRT. CONCLUSION: The majority of right and left AMRTs were related to the presence of ESA. Ablation can be successful with a favorable risk of atrial tachyarrhythmia recurrence.
Martin Fiala; Jan Chovancík; Radek Neuwirth; Renáta Nevralová; Otakar Jiravský; Libor Sknouril; Miloslav Dorda; Jaroslav Januska; Alexandra Vodzinská; Jindrich Cerný; Igor Nykl; Marian Branny
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article     Date:  2007-05-30
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  18     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-26     Completed Date:  2007-09-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  824-32     Citation Subset:  IM    
Department of Cardiology, Heart Center, Hospital Podlesí a.s., Trinec, Czech Republic.
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MeSH Terms
Body Surface Potential Mapping*
Catheter Ablation*
Heart Catheterization
Heart Conduction System / physiopathology*,  surgery*
Middle Aged
Tachycardia, Ectopic Atrial / complications,  physiopathology*,  surgery*
Treatment Outcome
Ventricular Dysfunction, Left / complications,  physiopathology

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