Electrophysiologic characteristics and catheter ablation of focal atrial tachycardia with more than one focus.
BACKGROUND
Information about the electrophysiologic characteristics and long-term outcome of catheter ablation in patients with multiple focal atrial tachycardia (AT) is limited.


OBJECTIVE
The purpose of this study was to investigate the electrophysiologic characteristics and long-term outcome of catheter ablation in patients with multiple focal AT.


METHODS
Two hundred fifty-one patients who were referred for radiofrequency catheter ablation of focal AT were included for analysis.


RESULTS
Forty-four patients who had focal AT with more than one focus were identified. Comparing focal AT with a single focus to that with more than one focus, the existence of a left atrial focus, cardiovascular comorbidity, nonparoxysmal tachycardia, shortest tachycardia cycle length, success rate of the ablation, and procedure time all differed. Multivariate logistic analysis revealed that a left atrial focus, cardiovascular comorbidity, and shortest tachycardia cycle length were independent predictors of focal AT with more than one focus. Noncontact mapping of the right atrium revealed larger low-voltage zone and longer total activation time for focal AT with more than one focus. Patients who had focal AT with more than one focus and a failed ablation had a greater number of focal ATs and mechanisms of nonparoxysmal tachycardia. Multivariate logistic analysis revealed that only the number of focal ATs predicted a failed ablation.


CONCLUSIONS
Focal ATs with more than one focus have different electrophysiologic characteristics. This study provides new insight into the development and atrial remodeling of focal AT with multiple foci.
Hu
Yu-Feng
YF
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Higa
Satoshi
S
Huang
Jin-Long
JL
Tai
Ching-Tai
CT
Lin
Yenn-Jiang
YJ
Chang
Shih-Lin
SL
Lo
Li-Wei
LW
Tuan
Ta-Chuan
TC
Chang
Chien-Jong
CJ
Tsai
Wen-Chin
WC
Lee
Pi-Chang
PC
Ishigaki
Sugako
S
Oyakawa
Asuka
A
Chen
Shih-Ann
SA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric; D013617:Tachycardia, Supraventricular / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome