Long-term outcome following successful catheter ablation of atrial tachycardia originating from the pulmonary veins: absence of late atrial fibrillation.
OBJECTIVE
This study aimed to characterize the long-term outcome and incidence of atrial fibrillation (AF) in patients following catheter ablation of focal atrial tachycardia (AT) from the pulmonary veins (PV).


BACKGROUND
Although both AT and AF may originate from ectopic foci within PVs, it is unknown whether PV AT patients subsequently develop AF.


METHODS
Twenty-eight patients with 29 PV ATs (14%) from a consecutive series of 194 patients who underwent RFA for focal AT were included. Patients with concomitant AF prior to the index procedure were excluded.


RESULTS
The minimum follow-up duration was 4 years; mean age 38 +/- 18 years with symptoms for 6.5 +/- 10 years, having tried 1.5 +/- 0.9 antiarrhythmic drugs. The distribution of foci was: left superior 12 (41%), right superior 10 (34%), left inferior 5 (17%), and right inferior 2 (7%). The focus was ostial in 93% and 2-4 cm distally within the vein in 7%. Mean tachycardia cycle length was 364 +/- 90 ms. Focal ablation was performed in 25 of 28 patients. There were 6 recurrences with 5 from the original site. Twenty-six patients were available for long-term clinical follow-up. At a mean of 7.2 +/- 2.1 years, 25 of 26 (96%) were free from recurrence off antiarrhythmic drugs. No patients developed AF.


CONCLUSIONS
Focal ablation for tachycardia originating from the PVs is associated with long-term freedom from both AT and AF. Therefore, although PV AT and PV AF share a common anatomic distribution, PV AT is a distinct clinical entity successfully treated with focal RFA and not associated with AF in the long term.
Teh
Andrew W
AW
Department of Cardiology, Royal Melbourne Hospital and the Department of Medicine, University of Melbourne, Melbourne, Australia.
Kalman
Jonathan M
JM
Medi
Caroline
C
Rosso
Raphael
R
Balasubramaniam
Richard
R
Lee
Geoffrey
G
Halloran
Karen
K
Sparks
Paul B
PB
Morton
Joseph B
JB
Vohra
Jitendra K
JK
Kistler
Peter M
PM
D000328:Adult; D001281:Atrial Fibrillation / Q000209:etiology* / Q000503:physiopathology; D017115:Catheter Ablation / Q000009:adverse effects*; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D018570:Risk Assessment; D012307:Risk Factors; D013617:Tachycardia, Supraventricular / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D014739:Victoria; D055815:Young Adult