Comparison of strategies for catheter ablation of focal atrial tachycardia originating near the His bundle region
| Autor: | Alessandro Proclemer, Luca Rebellato, Vitaly Lyashenko, Anatoly Nechepurenko, Massimiliano Manfrin, Evgeny Lyan, Mauro Toniolo, Alexandr Morozov, Grigory Gromyko, Alexey Tsyganov, Ayan Abdrahmanov, Marina Yakovleva |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Tachycardia Ectopic Atrial medicine.medical_specialty Bundle of His Radiofrequency ablation medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology law.invention Russia 03 medical and health sciences Electrocardiography 0302 clinical medicine law Recurrence Physiology (medical) medicine.artery Internal medicine medicine Humans 030212 general & internal medicine Heart Atria Atrioventricular Block Intraoperative Complications Atrial tachycardia Aorta Aged Retrospective Studies medicine.diagnostic_test business.industry Middle Aged medicine.disease Ablation Kazakhstan medicine.anatomical_structure Outcome and Process Assessment Health Care Italy Cardiology Catheter Ablation Female medicine.symptom Cardiology and Cardiovascular Medicine business Atrioventricular block |
| Zdroj: | Heart rhythm. 14(7) |
| ISSN: | 1556-3871 |
| Popis: | Recent studies have suggested that para-Hisian atrial tachycardia (AT) can be successfully ablated from the right atrium (RA), left atrium (LA), or noncoronary cusp (NCC) in the aorta; however, the best approach remains unclear.This study aimed to compare different approaches to radiofrequency catheter ablation (RFCA) of para-Hisian AT.We retrospectively analyzed 68 consecutive patients (49[72%] women; mean age 61 ± 13 years) treated with RFCA for this type of AT. Mapping of the RA (n = 68), LA (n = 21), and NCC (n = 52) was performed during AT to identify the earliest activation site and to apply RFCA.RFCA successfully terminated AT in the RA in 13 of 28 patients (46.4%), in the LA in 4 of 16 patients (25.0%), and in the NCC in 46 of 52 patients (88.5%) after 1 procedure (P.05). Atrioventricular block occurred only during RFCA in the RA in 4 of 28 patients (14.3%). After a mean follow-up of 33.5 ± 25.4 months, AT recurrence was observed in 5 of 13 patients (38.5%) ablated in the RA, 1 of 4 (25.0%) ablated in the LA, and 2 of 46 (4.4%) ablated in the NCC (P.05). RFCA in the LA was effective only if the local activation time (LAT) was earlier than that in the RA. RFCA in the NCC was successful regardless of the LAT (P.05).Mapping and ablation in the NCC should be always considered in cases of AT originating from the His bundle region, regardless of the LAT. |
| Databáze: | OpenAIRE |
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