title: Noncavotricuspid isthmus-dependent right atrial tachycardia after paroxysmal atrial fibrillation ablation.
abstract: BACKGROUND
  Atrial tachycardia (AT) is commonly encountered after atrial fibrillation (AF) ablation. But no study exclusively on noncavotricuspid isthmus-dependent right AT (NCTI-RAT) post-AF ablation has been reported. The present study aims to describe its prevalence, electrophysiological mechanisms, and ablation strategy and to further discuss its relationship with AF.
  
  
  METHODS
  From July 2006 to November 2009, 350 consecutive patients underwent catheter ablation for paroxysmal AF. A total of seven patients (2.0%) developed NCTI-RAT after left atrium ablation for AF. In these highly selected patients (two male, mean age 54 ± 11 years, mean left atrium diameter of 34 ± 7 cm), all had circumferential pulmonary vein isolation in their initial procedures and three of them had additional complex fractionated electrograms ablation in the left atrium and the coronary sinus.
  
  
  RESULTS
  Totally, nine NCTI-RATs were mapped and successfully ablated in the right atrium with a mean cycle length of 273 ± 64 ms in seven patients. Five ATs in three patients were electrophysiologically proved to be macroreentry and the remaining four were focal activation. All the ATs were successfully abolished by catheter ablation. After a mean follow-up of 29 ± 15 months post-AT ablation, all patients were free of AT and AF off antiarrhythmic drugs.
  
  
  CONCLUSIONS
  NCTI-RAT is relatively less common post-AF ablation. Totally, 2.0% of paroxysmal AF patients were revealed to have NCTI-RAT.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Weizhu
authors.initials: W
authors.lastname: Ju
authors.forename: Bing
authors.initials: B
authors.lastname: Yang
authors.forename: Hongwu
authors.initials: H
authors.lastname: Chen
authors.forename: Fengxiang
authors.initials: F
authors.lastname: Zhang
authors.forename: Lishang
authors.initials: L
authors.lastname: Zhai
authors.forename: Kejiang
authors.initials: K
authors.lastname: Cao
authors.forename: Minglong
authors.initials: M
authors.lastname: Chen
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D017115:Catheter Ablation / Q000706:statistics & numerical data*; D015984:Causality; D002681:China; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000453:epidemiology*; D016896:Treatment Outcome; D014261:Tricuspid Valve