Catheter ablation of tachycardias after undergoing a surgical atriotomy using a multipolar electrode catheter: conventional mapping method without an electroanatomical mapping system.
BACKGROUND
A variety of supraventricular tachyarrhythmias may occur in patients after undergoing a surgical atriotomy. The purpose of this study was to characterize them and determine the role of conventional mapping.


RESULTS
In 45 patients after a surgical atriotomy, 68 atrial tachyarrhythmias were observed. A conventional mapping system with a 20-pole electrode catheter used in the electrophysiological study detected 39 atrial tachycardias (ATs). Type 1 atrial flutter (AFL) was observed in 23 and reverse type 1 AFL in 4. AT was classified into 3 subgroups, namely, incisional macroreentrant AT (n=31), incisional focal AT (n=1) and non-incisional AT (n=7). In the patients with incisional macroreentrant AT after the standard right atriotomy, the 20-pole electrode catheter placed on the incision could easily record the entire sequence of the atrial activation. Successful catheter ablation was achieved in all patients with incisional reentrant AT. The ablation site of incisional reentrant AT was the isthmus between the incision and the superior vena cava cannulation scar in 4, between the incision and the inferior vena cava cannulation scar in 22, and the area at the septal incision in 3. The remaining 2 incisional ATs were left atrial AT and right atrial transincisional AT.


CONCLUSIONS
The conventional mapping system is still very useful for making an electrophysiological diagnosis in patients after a standard right atriotomy.
Division of Cardiology, Yokohama Rosai Hospital, Yokohama, Japan.
Motohiro
M
Nakao
Akihiko
A
Nogami
Aiko
A
Sugiyasu
Shoichi
S
Kubota
Hideki
H
Arima
Shinya
S
Kowase
Atsushi
A
Sakamoto
Kenji
K
Yaginuma
Hajime
H
Aoki
Kazuhiko
K
Yumoto
Toshiyuki
T
Tamaki
Kenichi
K
Kato
Hiroshi
H
Tada
Shigeto
S
Naito
D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000503:physiopathology* / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D017115:Catheter Ablation; D002404:Catheterization / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013610:Tachycardia / Q000503:physiopathology* / Q000628:therapy