title: Outcome of ablation for sustained focal atrial tachycardia in patients with and without a history of atrial fibrillation.
abstract: OBJECTIVE
  The aim of this study was to determine the long-term results of ablation for sustained focal atrial tachycardia in patients with and without a history of atrial fibrillation.
  
  
  METHODS
  A history of atrial fibrillation was documented in 25 of 111 patients (23%) with focal atrial tachycardias. We studied the results of focal ablation during a follow-up of 27 +/- 22 months.
  
  
  RESULTS
  Enlargement of left atrium (Odds ratio 2.99) and septal origin of the atrial focus (Odds ratio 5.68) were independent predictors of coexisting atrial fibrillation. Patients with a septal origin of the focal atrial tachycardia were older (62 vs. 54 years) and had a higher rate of structural heart disease than patients with a non-septal site of origin (51 vs. 29%). A higher rate of atrial fibrillation was found in patients with anteroseptal (56%), midseptal (50%) and posteroseptal (36%) atrial tachycardias than in patients with focal atrial tachycardias arising from the crista terminalis (9%), the tricuspid (12%) and mitral annulus (0%), the ostia of thoracic veins (17%) and other right atrial (27%) and left atrial free wall sites (10%). During the follow-up, atrial fibrillation was documented in 3% of patients without preexisting atrial fibrillation. In patients with focal atrial tachycardia and a history of atrial fibrillation, at least one episode of atrial fibrillation was documented during follow-up in 64% of patients, but 60% of patients reported marked symptomatic improvement.
  
  
  CONCLUSIONS
  An increased rate of coexisting atrial fibrillation was found in patients with a septal origin of focal atrial tachycardia. Ablation of the focal atrial tachycardia may eliminate both arrhythmias, but patients with a history of atrial fibrillation may still be prone to recurrences of atrial fibrillation after focal ablation.
authors.affiliation: Medzomoscje Klinik 1, Klinikum Grosshadern, universität München, Germany. Christopher.Reithmann@med.uni-muenchen.de
authors.forename: Christopher
authors.initials: C
authors.lastname: Reithmann
authors.forename: Uwe
authors.initials: U
authors.lastname: Dorwarth
authors.forename: Michael
authors.initials: M
authors.lastname: Fiek
authors.forename: Tomas
authors.initials: T
authors.lastname: Matis
authors.forename: Thomas
authors.initials: T
authors.lastname: Remp
authors.forename: Gerhard
authors.initials: G
authors.lastname: Steinbeck
authors.forename: Ellen
authors.initials: E
authors.lastname: Hoffmann
mesh_terms: D001281:Atrial Fibrillation / Q000150:complications*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric; D013617:Tachycardia, Supraventricular / Q000150:complications* / Q000601:surgery*; D016896:Treatment Outcome
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