Characteristics, Mechanism and Long-Term Ablation Outcome of Atrial Tachycardias After Mitral Valvular Surgery and Concomitant Cox-MAZE IV Procedure
| Autor: | Hui-Ming Guo, Fangzhou Liu, Xianhong Fang, Hung-Fat Tse, Yang-Qiu Li, Jian Liu, Hai Deng, Hongtao Liao, Jo-Jo Hai, Yumei Xue, Huanlei Huang, Shulin Wu, Xianzhang Zhan |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Epicardial Mapping Male Tachycardia Ectopic Atrial medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Pulmonary vein Lesion 03 medical and health sciences 0302 clinical medicine Heart Rate Humans Medicine Sinus rhythm 030212 general & internal medicine Cardiac Surgical Procedures Atrial tachycardia Aged business.industry Incidence Rheumatic Heart Disease General Medicine Reentry Middle Aged Ablation Surgery Catheter Treatment Outcome Concomitant Catheter Ablation Mitral Valve Female medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | International Heart Journal. 60:71-77 |
| ISSN: | 1349-3299 1349-2365 |
| DOI: | 10.1536/ihj.18-117 |
| Popis: | The incidence of atrial tachycardia (AT) after rheumatic mitral valvular (RMV) surgery has been well described. However, there have been few reports on the characteristics, mechanism, and long-term ablation outcome of ATs after RMV surgery and concomitant Cox-MAZE IV procedure.The present study reviewed consecutive patients who underwent AT ablation between May 2008 and July 2013. All patients were refractory to antiarrhythmic drugs (AADs) and had a history of RMV surgery and Cox-MAZE IV procedure. A total of 34 patients underwent AT ablation after RMV surgery and concomitant Cox-MAZE IV procedure, and presented 57 mappable and 2 unmappable ATs. The 57 mappable ATs included 14 focal-ATs and 43 reentry-ATs. Ten of the 14 focal-like ATs were located at the pulmonary vein (PV) antrum and border of a box lesion. Of the 43 reentry-ATs, 16 were marco-reentrant around the mitral annulus (MA) and 16 around the tricuspid annulus. There were 41 atypical ATs (non-cavotricuspid isthmus related) including 16 ATs related to the box lesion and 21 ATs related to other Cox-MAZE IV lesions. The AT were successfully terminated in 33 (97.1%) patients. After mean follow-up of 46.9 ± 15.7 months, 25 (73.5%) patients maintained sinus rhythm without AADs after a single procedure and 28 (82.4%) patients after repeated procedures.The recurrent ATs after RMV surgery and concomitant Cox-MAZE IV were mainly reentry mechanism, and largely related to LA. An incomplete lesion or re-conductive gaps in a prior lesion might be the predominant mechanisms for these ATs. Catheter-based mapping and ablation of these ATs seems to be effective and safe during a long-term follow-up. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|