Atrial tachycardias following circumferential pulmonary vein ablation: observations during catheter ablation.
Circumferential pulmonary vein ablation performing linear lesions around the ostia of the pulmonary veins has been shown to be effective for the treatment of atrial fibrillation. During the follow-up period, persistent atrial tachycardia may occur as a proarrhythmic complication. Only little information is available about the underlying mechanism. In our study, atrial tachycardia following circumferential pulmonary vein ablation was identified in 13 out of 84 consecutive patients (15.5%), as a transient appearance in four and with recurrences for more than 3 months in nine patients (10.7%). Electrophysiological study and ablation was performed in eight cases, revealing common atrial flutter in two, a focal origin secondary to conduction recovery from the pulmonary vein to the left atrium in two and macro reentrant left atrial flutter in four patients. The electrophysiological characteristics demonstrated by electroanatomic activation mapping CARTO and consecutive ablation therapy with a 100% success rate are described and discussed with regard to the literature.
Kooperatives Kölner Herzzentrum beidseits des Rheins, Cologne, Germany. m.horlitz@khporz.de
Marc
M
Horlitz
Philipp
P
Schley
Dong-In
DI
Shin
Beatrice
B
Tonnellier
Hartmut
H
Gülker
D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation / Q000379:methods*; D015331:Cohort Studies; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods; D011336:Probability; D011667:Pulmonary Veins / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome