Ablation of 'Background Tachycardia' in Long Standing Atrial Fibrillation: Improving the Outcomes by Unmasking a Residual Atrial Fibrillation Perpetuator
| Autor: | Mauricio Arruda, Juán Carlos Zerpa A, Remy Nelson Albornoz, Tomas G Santillana P, Tasso Julio Lobo, Jose Carlos Pachon-M, Carlos Thiene Cunha Pachón, Juan Carlos Pachon-M, Felipe Ortencio, Enrique I. Pachon-M |
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| Rok vydání: | 2017 |
| Předmět: |
Tachycardia
medicine.medical_specialty business.industry medicine.medical_treatment Catheter ablation Atrial fibrillation 030204 cardiovascular system & hematology Ablation medicine.disease Culprit Pulmonary vein 03 medical and health sciences 0302 clinical medicine Internal medicine Cardiology Medicine Spectral analysis 030212 general & internal medicine medicine.symptom Cardiology and Cardiovascular Medicine business Complication Original Research |
| Zdroj: | Journal of Atrial Fibrillation. 10 |
| ISSN: | 1941-6911 |
| Popis: | Background Catheter ablation of long-standing persistent AF (LSAF) remains challenging. Since AF-Nest (AFN) description, we have observed that a stable, protected, fast source firing, namely "Background Tachycardia"(BT), could be hidden beneath the chaotic AF. Following pulmonary vein isolation (PVI)+AFN ablation one or more BT may arise or be induced in 30-40% of patients, which could be the culprit forAF maintenance and ablation recurrences. Methods and Results We studied 114 patients, from 322 sequential LSAF regular ablations, having spontaneous or induced residual BT after EGM-guided PVI+AFN ablation of LSAF; 55.6±11y/o, 97males (85.1%), EF=65.5±8%, LA=42.8±6.7mm. Macroreentrant tachycardias were excluded. Pre-ablationAF 12-leads ECG Digital processing(DP) and spectral analysis(SA) was performed searching for BT before AF ablation and its correlation with BT during ablation.After PVI, 38.1±9 AFN sites/patient and 135 sustained BTs (1-3, 1.2±0.5/patient) were ablated. BT cycle length(CL) was 246.3±37.3ms. In 79 patients presenting suitable DP for SA, the BT-CL was 241.6±34.3ms with intra procedure BT-CL correlation r=0.83/p |
| Databáze: | OpenAIRE |
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