Document Detail


Characterization of focal right atrial appendage tachycardia.
MedLine Citation:
PMID:  18077484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Though right atrial appendage tachycardia (RAAT) has been described, no studies to date have focused on its clinical characterization. The aim of the present study was to analyze its clinical, electrocardiographic (ECG), and electrophysiologic (EP) characteristics and the results of radiofrequency ablation (RFA) in RAAT. METHODS AND RESULTS: Out of 186 consecutive patients undergoing RFA for AT, 15 (8%) had focal RAAT. Mapping was performed using conventional catheters or a 3D electroanatomic mapping system. Patients with RAAT were more likely to be male (66 vs. 38%; P= 0.013) and younger (32 +/- 12.6 vs. 55 +/- 13.2 years; P < 0.001) than patients with AT originating elsewhere. They were also more likely to have dyspnea (27 vs. 7.6%; P = 0.03), incessant tachycardia (53 vs. 16%; P < 0.001), and left ventricular systolic dysfunction (27 vs. 5%; P = 0.018). RFA was effective in all patients (100 vs. 75%; P = 0.022) and no recurrences (0 vs. 8%; P = 0.31) were observed during a mean follow-up of 37 +/- 36 months. A specific ECG pattern was identified, consisting of negative P-waves in leads V1-V2 and a transition to positivity in the rest of the precordial leads. This ECG pattern correctly identified RAAT with a sensitivity of 100%, a specificity of 98%, a positive predictive value of 88%, and a negative predictive value of 100%. CONCLUSION: Right atrial appendage tachycardia is more prevalent in young male patients and is commonly associated with tachycardiomyopathy. RFA is effective over long-term follow-up. A characteristic ECG pattern identifies RAAT with a very high sensitivity and specificity.
Authors:
Xavier Freixa; Antonio Berruezo; Lluís Mont; Santiago Magnani; Begoña Benito; Jose María Tolosana; Pablo Perafan; David Tamborero; Josep Brugada
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Publication Detail:
Type:  Journal Article     Date:  2007-12-12
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  10     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-01-17     Completed Date:  2008-03-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  105-9     Citation Subset:  IM    
Affiliation:
Arrhythmia Section, Cardiology Department, Thorax Institute, Hospital Clinic, University of Barcelona, Villarroel 170, Barcelona 08036, Catalonia, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Appendage / physiopathology*,  surgery
Catheter Ablation
Dyspnea / etiology,  physiopathology
Electrocardiography*
Electrophysiologic Techniques, Cardiac
Female
Follow-Up Studies
Humans
Longitudinal Studies
Male
Middle Aged
Predictive Value of Tests
Sensitivity and Specificity
Tachycardia, Ectopic Atrial / complications,  physiopathology*,  surgery
Treatment Outcome
Ventricular Dysfunction, Left / etiology,  physiopathology

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