Atrial Tachycardia Arising From the Crista Terminalis, Detailed Electrophysiological Features and Long-Term Ablation Outcomes
| Autor: | Patrick M. Heck, Peter M. Kistler, Tomos E. Walters, Paul B. Sparks, Ashley Nisbet, Louise Segan, Jonathan M. Kalman, Gareth J. Wynn, Joseph B. Morton, Gwilym M. Morris, Geoff R. Wong, Troy Watts |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Tachycardia medicine.medical_specialty medicine.medical_treatment Catheter ablation 030204 cardiovascular system & hematology Single Center ablation Electrocardiography 03 medical and health sciences Postoperative Complications 0302 clinical medicine Internal medicine Atrial Fibrillation medicine Humans Heart Atria 030212 general & internal medicine Atrial tachycardia Retrospective Studies crista terminalis medicine.diagnostic_test business.industry Atrial fibrillation Middle Aged atrial tachycardia medicine.disease Ablation Treatment Outcome medicine.anatomical_structure Catheter Ablation Cardiology Female medicine.symptom Crista terminalis business |
| Zdroj: | Morris, G M, Segan, L, Wong, G, Wynn, G, Watts, T, Heck, P, Walters, T E, Nisbet, A, Sparks, P, Morton, J B, Kistler, P M & Kalman, J M 2019, ' Atrial Tachycardia Arising From the Crista Terminalis, Detailed Electrophysiological Features and Long-Term Ablation Outcomes ', JACC: Clinical Electrophysiology, vol. 5, no. 4, pp. 448-458 . https://doi.org/10.1016/j.jacep.2019.01.014 |
| DOI: | 10.1016/j.jacep.2019.01.014 |
| Popis: | Objectives The goal of this study was to characterize, in detail, focal atrial tachycardia (AT) arising from the crista terminalis to investigate associations with other atrial arrhythmia and to define long-term ablation outcomes. Background The crista terminalis is known to be the most common site of origin for focal AT, but it is not well characterized. Methods This study retrospectively identified a total of 548 ablation procedures for AT performed at a single center over a 16-year period, of which 171 were arising from the crista terminalis. Results Compared with patients with other AT sites of origin, crista terminalis AT patients were older (57.3 vs. 47.3 years), more commonly female (72.9% vs. 59.1%), were more commonly associated with coexistent atrioventricular nodal re-entry tachycardia (17.1% vs. 9.7%), and were more likely to be inducible with programmed stimulation (81.5% vs. 58.9%). There was preferential conduction in the superior-inferior axis along the crista terminalis. Acute ablation success rate was high (92.2%) and improved significantly when three-dimensional mapping was used (98.5%). Recurrence in the first 12 months after a successful ablation was 9.7%. Only 2 patients developed atrial fibrillation over the long-term follow-up of >7 years. Conclusions This large series characterized the clinical and electrophysiological features and immediate and long-term ablation outcomes for AT originating from the crista terminalis. Features of the tachycardia suggest that age-related localized remodeling of the crista terminalis causes a superficial endocardial zone of conduction slowing leading to re-entry. Ablation outcomes were good, with long-term freedom from atrial arrhythmia. |
| Databáze: | OpenAIRE |
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