Document Detail


Focal left atrial tachycardias not associated with prior catheter ablation for atrial fibrillation: clinical and electrophysiological characteristics.
MedLine Citation:
PMID:  21967474     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The clinical features and electrophysiological characteristics of patients with focal left atrial tachycardias (LATs) are not well characterized. This study reports the experience of a single center in catheter mapping and radiofrequency ablation of focal LAT not associated with prior atrial fibrillation (AF) ablation, including in cardiac sarcoidosis and transplant patients.
METHODS: Patients with focal LAT without a history of AF ablation were included in this retrospective analysis.
RESULTS: A total of 24 focal LATs were documented in 20 patients. Two patients were subsequently diagnosed with cardiac sarcoidosis. Two patients were status post a thoracic transplant. The mean initial cycle length of the focal LATs was 347.4 ± 96.2 ms (range 190-510 ms). Patients with a pulmonary vein (PV) ostium focus (n = 6) demonstrated a shorter cycle length than patients with other LA foci (259.2 ± 56.4 ms vs 371.9 ± 91.1 ms, P = 0.02), as well as a trend for a history of AF (67% vs 21%, P = NS). Catheter ablation was immediately successful for 19 of 22 focal LATs.
CONCLUSIONS: Focal LATs not associated with prior AF ablation can originate in a variety of LA locations and clinical settings. Focal LAT arising in the PV ostia is associated with a history of AF and demonstrates a faster tachycardia rate. We also report focal LAT in cardiac sarcoidosis patients and in the donor heart of an orthotopic heart transplant recipient. Radiofrequency ablation is a successful treatment for focal LAT not associated with prior ablation, including those refractory to medical therapy.
Authors:
Angelo B Biviano; William Bain; William Whang; Joshua Leitner; José Dizon; Kathleen Hickey; Hasan Garan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-10-03
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  35     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-13     Completed Date:  2012-05-22     Revised Date:  2014-11-14    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  17-27     Citation Subset:  IM    
Copyright Information:
©2011, The Authors. Journal compilation ©2011 Wiley Periodicals, Inc.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / complications,  diagnosis*,  surgery*
Body Surface Potential Mapping*
Catheter Ablation*
Female
Humans
Male
Middle Aged
Tachycardia, Ectopic Atrial / complications,  diagnosis*,  surgery*
Treatment Outcome
Young Adult

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


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