A case of successful termination of an atrial tachycardia ablated from the pulmonary artery during rapid ventricular pacing (original) (raw)
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The Role of Catheter Ablation in Atrial Tachycardia, Flutter, and Fibrillation
Journal of Interventional Cardiology, 1995
The first experiences of nonpharmacologit~ul treatment of ectopic atrial tachycardia (EAT), common atrial flutter (AFI), anti atrial ,fibrillation (AF) were performed by surgical techniques. Many studies reported a very high success rate on the use of catheter ablution with radiofrequency current for the treatment of supraventricular arrhythmias; and recently, various preliminary reports are dedicated to the treatment of EAT, AF1, and AF with that source of energy. To our knowledge 108 cases of EAT treated by catheter ablation of the ectopic focus are reported in the literature with a success rate superior to 90%. On the basis of our personal experience regarding 11 cases (4 oJ right atrium EAT and 7 of left) we discuss here the essential role of unipolar leads derived from the mapping catheter to select the target f o r radiofrequenc-y applications. Two hundred and one cases of AFl tested by catheter ablation were previously reported. The majority of them (> 80%) were successfully treated with radiofiequenc.y. Some working groups performed the procedure as the basis ojelectrophysiologicalfindings, while others preferred an anatomical approach applying radiofrequency energy at the isthmus lying between the coronary sinus ostium and the tricuspid ring, near the vena cava orifice. On the basis of these assumptions, we obtained 83% of final success in 12 cases of AFl treated by radiofrequency. Finally, we discuss the problem related to the modulation of atrioventricular (AV-) nodal conduction during AF. In our laboratory, five cases with chronic AF and very fast ventricular response were treated with radiofrequency with a posterior septa1 approach. In a11 patients, we obtained very encouraging results with a constant decrease of ventricular rate (from 137 5 33 to 69 k 14 heats per minute). All cases treated by modulation of AV nodal conduction demonstrated an appropriate chronotropic response to the variations of the functional state that persists during the follow-up. More e-rperience with longer .follow-up and accurate pre-and postprocedure evaluations are needed to finalize the most appropriate technique of radi'ofrequency applications in these cases. (J Interven Cardiol 1995;8 (Suppl): 793-805) Ectopic Atrial Tachycardia Ectopic Atrial Tachycardia (EAT) is an uncommon arrhythmia since it concerns no more than 1% of the patients with supraventricular arrhythmias referred for electrophysiological evaluation. I Several studies on incessant forms of EAT in childhood have been reported, but this arrhythmia may occur also in young Dr. Stanke and Dr. Maid were recipients of grants from "Minister0 degli Affari Esteri.
Heart, lung & circulation, 2015
Ablation of focal atrial tachycardia (AT) originating from the interatrial septum (IAS) is challenging because of its complex anatomy. We studied the electrocardiographic and electrophysiologic characteristics of focal, septal AT in seven patients who underwent successful ablation. The site of successful ablation was at the site of earliest activation on the right side of the IAS in three patients and on the left side in four patients, >1cm away from the centre of the fossa ovalis in the septum secundum. A negative or +/- versus a positive or -/+ P wave in lead V1 during AT accurately predicted a right- versus left-sided origin of the AT, respectively. In the four left septal AT cases, right atrial activation mapping opposite the site of successful ablation revealed the presence of a small, low-frequency potential followed by a larger, high-frequency potential. In contrast, a high-frequency potential was not preceded by a low-frequency potential in the three right septal AT cases...
Right atrial thrombus formation after transvenous catheter ablation of the atrioventricular node
Journal of the American College of Cardiology, 1985
The formation of a right atrial mass was detected in a patient by two-dimensional echocardiography 3 weeks after successful transvenous electrical ablation of the atrioventricular node had been performed. The mass was attached to the atrial septum at the site where the electrode catheter used for the ablation had supposedly been located and it exhibited no mobility. It was inter-Transvenous catheter ablation of the atrioventricular (A V) node is an effective treatment for selected patients with various types of drug-resistant supraventricular arrhythmias. Complications have been observed in only a small number of patients (1-3). We report on the formation of a right atrial thrombus at the site where the A V node had been successfully ablated by this technique.
International Heart Journal, 2011
Left atrial roof line (LARL) can prevent the perpetuation of atrial fibrillation (AF) by delineation of the arrhythmogenic substrate, but it may be associated with an increased incidence of atrial tachycardia (AT). This study was performed to evaluate the characteristics and clinical implications of inducible AT after LARL. A total of 139 consecutive patients with AF who underwent catheter ablation were prospectively enrolled in this study. LARL was required to prevent the perpetuation of AF in 98 of 139 patients (71%). LARL significantly reduced the incidence of inducible AF (before versus after: 100% versus 44%, respectively, P < 0.01), whereas it significantly increased the incidence of AT (18% versus 63%, P < 0.01). ATs were observed after LARL in 62 of 98 patients (63%), and these circuits were determined in 99 of 112 stable ATs (88%), including tricuspid isthmus-dependent (n = 35), mitral annulus (n = 22), septal (n = 15), surrounding right pulmonary veins (PVs) (n = 12), coronary sinus (CS) ostium (n = 4), upper loop (n = 4), surrounding left PVs (n = 4), and LA anterior wall (n = 3). Catheter ablation (CA) successfully terminated 111 of 122 stable ATs (91%) during CA. The occurrence of AT after CA was significantly higher in patients with than in those without residual AT (26% versus 2%, P < 0.05). Induced AT with a stable circuit after LARL creation could be mapped, and delineation of the induced AT may lead to a favorable outcome.