Document Detail

Catheter ablation of atypical atrial flutter and atrial tachycardia within the coronary sinus after left atrial ablation for atrial fibrillation.
MedLine Citation:
PMID:  15992640     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The goal of this study was to describe the prevalence and ablation of coronary sinus (CS) arrhythmias after left atrial ablation for atrial fibrillation (AF). BACKGROUND: The CS has been implicated in a variety of supraventricular arrhythmias. METHODS: Thirty-eight patients underwent mapping and ablation of atypical flutter that developed during (n = 5) or after (n = 33) ablation for AF. Also included were two patients with focal CS arrhythmias that occurred during an AF ablation procedure. A tachycardia was considered to be originating from the CS if the post-pacing interval in the CS matched the tachycardia cycle length and/or if it terminated during ablation in the CS. RESULTS: Among the 33 patients who developed atypical flutter late after AF ablation, 9 (27%) were found to have a CS origin. Overall, 16 of the 40 patients in this study had a CS arrhythmia. The tachycardia was macro-re-entrant in 14 patients (88%) and focal in two patients. Radiofrequency ablation with an 8-mm-tip catheter was successful in 15 patients (94%) without complication. In eight patients (50%), > or = 45 W was required for successful ablation. Thirteen of the 15 patients (87%) with a successful ablation acutely remained arrhythmia-free during 5 +/- 5 months of follow-up. CONCLUSIONS: The musculature of the CS serves as a critical component of the re-entry circuit in approximately 25% of patients with atypical flutter after ablation for AF. The CS may also generate focal atrial arrhythmias that may play a role in triggering and/or maintaining AF. Catheter ablation of these arrhythmias in the CS can be performed safely.
Aman Chugh; Hakan Oral; Eric Good; Jihn Han; Kamala Tamirisa; Kristina Lemola; Darryl Elmouchi; David Tschopp; Scott Reich; Petar Igic; Frank Bogun; Frank Pelosi; Fred Morady
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  46     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-04     Completed Date:  2005-07-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  83-91     Citation Subset:  AIM; IM    
Division of Cardiology, University of Michigan Hospitals, Ann Arbor, Michigan, USA.
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MeSH Terms
Arrhythmia, Sinus / etiology*,  physiopathology,  surgery*
Atrial Fibrillation / surgery*
Catheter Ablation / adverse effects*
Follow-Up Studies
Middle Aged
Sinoatrial Node / physiopathology*,  surgery*
Treatment Outcome

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

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