Document Detail

Focal atrial tachycardia originating from the left atrial appendage: electrocardiographic and electrophysiologic characterization and long-term outcomes of radiofrequency ablation.
MedLine Citation:
PMID:  17456134     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: This study sought to investigate electrophysiologic characteristics and radiofrequency ablation (RFA) in patients with focal atrial tachycardia (AT) arising from the left atrial appendage (LAA). METHODS: This study included seven patients undergoing RFA with focal AT. Activation mapping was performed during tachycardia to identify an earlier activation in the left atria and the LAA. The atrial appendage angiography was performed to identify the origin in the LAA before and after RFA. RESULTS: AT occurred spontaneously or was induced by isoproterenol infusion rather than programmed extrastimulation and burst atrial pacing in any patient. The tachycardia demonstrated a characteristic P-wave morphology and endocardial activation pattern. The P wave was highly positive in inferior leads in all patients. Lead V1 showed upright or biphasic (+/-) component in all patients. Lead V2-V6 showed an isoelectric component in five patients or an upright component with low amplitude (<0.1 mV) in two patients. Earliest endocardial activity occurred at the distal coronary sinus (CS) ahead of P wave in all seven patients. Mean tachycardia cycle length was 381 +/- 34 msec and the earliest endocardial activation at the successful RFA site occurred 42.3 +/- 9.6 msec before the onset of P wave. RFA was acutely successful in all seven patients. Long-term success was achieved in seven of the seven over a mean follow-up of 24 +/- 5 months. CONCLUSIONS: The LAA is an uncommon site of origin for focal AT (3%). There were consistent P-wave morphology and endocardial activation associated with this type of AT. The LAA focal ablation is safe and effective. Long-term success was achieved with focal ablation in all patients.
Yun-Long Wang; Xue-Bin Li; Xin Quan; Jin-Xin Ma; Ping Zhang; Yuan Xu; Hai-Cheng Zhang; Ji-Hong Guo
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  18     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2007 May 
Date Detail:
Created Date:  2007-04-25     Completed Date:  2007-05-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  459-64     Citation Subset:  IM    
Department of Cardiology, People's Hospital, University of Peking, Peking, China.
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MeSH Terms
Atrial Appendage / surgery*
Catheter Ablation / methods*
Electrocardiography / methods*
Heart Conduction System / surgery*
Longitudinal Studies
Middle Aged
Tachycardia, Ectopic Atrial / diagnosis*,  surgery*
Treatment Outcome
Comment In:
J Cardiovasc Electrophysiol. 2007 May;18(5):465-6   [PMID:  17388910 ]

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