Radiofrequency catheter ablation of atrial tachycardia under navigation using the EnSite array.
BACKGROUND
Atrial tachycardia (AT) is sometimes difficult to eliminate by radiofrequency ablation (RFA), but the EnSite array (EA) visualizes the beat-to-beat virtual activation of any tachycardia.


RESULTS
The 51 patients with 74 ATs (mean age 57+/-18 years, 28 males) undergoing EA-guided RFA were included; 14 patients had had previous open heart surgery and 5 had organic heart disease. RFA was performed at the AT focus for focal AT (n=48) with an endpoint of AT termination and subsequent non-inducibility. RFA was performed at a critical conducting pathway for reentrant AT (n=26) with creation of a block line in the critical reentry circuit. EA revealed that 57 ATs originated in the right atrium (77%) and 17 originated in the left atrium (23%); all but 1 were successfully eliminated. Fluoroscopic time was 19+/-11 min, the number of RFA applications was 8+/-7, and the radiofrequency energy was 10,711+/-12,655 J. No complications were noted. All but 2 patients were free of any symptoms during a follow-up of 16+/-9 months.


CONCLUSIONS
EA-guided RFA is safe and effective for AT, irrespective of its mechanism, sustainability or origin, and regardless of underlying heart disease. (Circ J 2010; 74: 59 - 65).
Narita
Sumito
S
EP Expert Doctors-Team Tsuchiya, Japan.
Miyamoto
Koji
K
Tsuchiya
Takeshi
T
Nagamoto
Yasutsugu
Y
Yamaguchi
Takanori
T
D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D004562:Electrocardiography; D004566:Electrodes; D022062:Electrophysiologic Techniques, Cardiac / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013612:Tachycardia, Ectopic Atrial / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome