[Radiofrequency catheter ablation for atrial tachycardia].
BACKGROUND
Radiofrequency catheter ablation of atrial tachycardia guided by bipolar activation mapping has been reported in the last years. This article reports the use of radiofrequency catheter ablation for the treatment of atrial tachycardia using simultaneous bipolar and unipolar activation mapping at our institution.


METHODS
Nine patients (7 male and 2 female, mean age 37.2 +/- 24.1 years), were selected for radiofrequency catheter ablation of drug refractory atrial tachycardia. Mapping procedure included an investigation of the local earliest bipolar and unipolar activity and unipolar morphology analysis.


RESULTS
Atrial tachycardia was successfully ablated in 7 patients (78%) with an average number of 6.8 +/- 3.1 RF pulses. Procedure related complications and tachycardia follow-up recurrences were not observed in any patient. Bipolar local activation time was significantly shorter at successful than at unsuccessful ablation sites (-30 +/- 21.1 ms vs -18.3 +/- 20.6 ms; p = 0.01). No difference was observed in unipolar local activation time between successful and unsuccessful sites (-22.5 +/- 26.2 ms vs -19.8 +/- 21.5 ms; p = 0.56). Accurate localization of the successful ablation site by unipolar electrogram analysis was not feasible because a "QS" pattern was found at both 21 unsuccessful and 2 successful ablation sites. Finally, a fast slope of the negative deflection of the unipolar electrogram was found at 2 out of 45 unsuccessful and 3 out of 6 successful ablation sites.


CONCLUSIONS
Radiofrequency catheter ablation of atrial tachycardia is feasible without complications in most patients. Bipolar activation mapping accurately localizes the successful ablation site. A "QS" pattern is not predictive of successful radiofrequency application.
Merino Lloréns
J L
JL
Departamento de Cardiología, Hospital General Gregorio Marañón, Madrid.
Arenal Maíz
A
A
Pérez-Villacastín
J
J
Almendral Garrote
J
J
Peinado Peinado
R
R
Medina Moreno
O
O
Maroto Monedero
C
C
Delcán Domínguez
J L
JL
D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013612:Tachycardia, Ectopic Atrial / Q000503:physiopathology / Q000601:surgery*
Ablación con catéter mediante radiofrecuencia de taquicardias auriculares.