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Journal of Interventional Cardiac Electrophysiology
Erschienen in: Journal of Interventional Cardiac Electrophysiology 2/2016

21.09.2015

Clinical significance of induced left atrial macro-reentrant tachycardia after pulmonary vein isolation

verfasst von: Hideyuki Hara, Masahiro Yoshinaga, Yumie Matsui, Satoshi Yamamoto, Takahiro Ishido, Kotaro Yutaka, Tomonori Kasuu, Masahiro Karakawa

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 2/2016

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Abstract

Background

The clinical significance of induced left atrial macro-reentrant tachycardia (LA-AT) after encircling pulmonary vein isolation (EPVI) is unclear. Our objective was to determine whether induced LA-ATs are associated with the clinical recurrence of ATs.

Methods

We studied 185 consecutive patients with paroxysmal atrial fibrillation (PAF) who underwent their first EPVI with an 8-mm tip, nonirrigated catheter approach. AT was induced by atrial burst pacing after the completion of EPVI, and the atrial activation pattern was evaluated using EnSite NavX. Induced LA-ATs were ablated only in patients with clinical ATs of suspected LA origin. The factors associated with occurrence of AT after the procedure were examined.

Results

LA-ATs were induced in 38 patients and ablated in 5 patients. During a follow-up of 23 ± 7 months, the occurrence of AT did not differ between patients with nonablated LA-ATs (4/33, 12 %) and those without any inducible ATs (16/113, 14 %, p > 0.99). In multivariate analysis, the number of ablation points for completing EPVI was the only independent predictor of AT occurrence (odds ratio 1.07, p < 0.01). A repeat procedure was performed in 22 of 26 patients who developed AT. Nineteen patients became free from AT and AF after ablation of the conduction gaps (EPVI, n = 17; another line, n = 4), extra PV firing (n = 4), focal AT (n = 4), and induced LA-ATs (n = 3).

Conclusions

In patients who had EPVI for PAF using an 8-mm tip, nonirrigated catheter, the occurrence of AT after EPVI was mainly due to conduction gaps in the ablation line or extra PV triggers. In patients with PAF, LA-ATs induced during the first procedure did not require ablation if they were not associated with clinical AT.
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Metadaten
Titel
Clinical significance of induced left atrial macro-reentrant tachycardia after pulmonary vein isolation
verfasst von
Hideyuki Hara
Masahiro Yoshinaga
Yumie Matsui
Satoshi Yamamoto
Takahiro Ishido
Kotaro Yutaka
Tomonori Kasuu
Masahiro Karakawa
Publikationsdatum
21.09.2015
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 2/2016
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-015-0055-8

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