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Erschienen in: Journal of Interventional Cardiac Electrophysiology 1/2019

01.12.2018

Focal atrial tachycardia ablation: Highly successful with conventional mapping

verfasst von: Antonis S. Manolis, Kyriakos Lazaridis

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 1/2019

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Abstract

Background/objective

Radiofrequency catheter ablation (RFCA) of focal atrial tachycardia (FAT) traditionally is guided by conventional endocardial mapping of earliest atrial activation; however, more recently electro-anatomical mapping is heralded as a more effective, albeit more expensive, tool to guide ablation. Herein we present the results of conventional mapping-guided RFCA. Apropos, we conducted a literature search of studies reporting > 10 FAT patients submitted to RFCA.

Methods and results

Conventional mapping-guided RFCA, performed in 63 FAT patients (aged 42.4 + 17.3 years; 14 with incessant tachycardia and 12 with tachycardiomyopathy (TCM)), was successful in 61 (96.8%) patients, applied for single foci in 59 (93.7%) and two foci in 4 patients, right (n = 46) or left sided (n = 17). The earliest atrial activation time at the ablation site was 41.3 ± 16.2 ms. Fluoroscopy time averaged 27.3 + 18.7 min, and procedure lasted 2.6 + 1.7 h. Complications occurred in two patients (sinus pauses in one needing a pacemaker and a large inguinal hematoma in one). Over 29.0 + 22.9 months, four patients (6.5%) had recurrences, of whom three were successfully re-ablated. All patients with TCM showed gradual improvement to normalization over 4–6 months. Literature search showed that RFCA success is equally high when guided with either conventional (88.5%) or electro-anatomical mapping (90%) with similar recurrences (9.6% vs. 9.5%).

Conclusion

Conventional mapping-guided RFCA of FAT had high success (96.8%) with low complication (3.2%) and recurrence rates (6.5%). TCM was fully reversible. These results are comparable to those achieved with the more expensive electro-anatomical mapping, which may be reserved for more complex cases or for those failing the conventional approach.
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Metadaten
Titel
Focal atrial tachycardia ablation: Highly successful with conventional mapping
verfasst von
Antonis S. Manolis
Kyriakos Lazaridis
Publikationsdatum
01.12.2018
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 1/2019
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-018-0493-1

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