title: Localized reentry as a novel type of the proarrhythmic effects of linear ablation in the left atrium.
abstract: BACKGROUND
  There is a consistent understanding that the proarrhythmic effect of linear ablation in the left atrium body for atrial fibrillation (AF) always manifests as the macroreentry tachycardia. However, its genesis of localized reentry has been underestimated.
  
  
  METHODS
  Among 90 persistent AF patients who had accepted linear ablation in the left atrium body, a total of 11 patients (12%) presented with a localized reentry (six men, mean age 59 ± 11 years) associated with previous ablation lines. Among the 11 patients, four were encountered during the index procedure for AF ablation and the remaining seven during the redo procedure for atrial tachycardias (ATs).
  
  
  RESULTS
  The ATs were all located at previously ablated lesion sites and manifested a centrifugal mode in both the activation mapping and pattern of the postpacing interval response. The mean tachycardia cycle length (TCL) of the localized reentrant ATs was 306 ± 73 ms. The target sites demonstrated low amplitude (0.17 ± 0.09 mV) continuous complex electrograms or long double potentials, covering 142 ± 57 ms (46 ± 12 % of the TCL). The localized reentrant tachycardias were all successfully eliminated by catheter ablation.
  
  
  CONCLUSIONS
  A novel type of the proarrhythmic effects of linear ablation in the left atrium for AF may manifest as localized reentrant ATs, as evidenced by the association of the site of origin with the prior lesions.
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: D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013612:Tachycardia, Ectopic Atrial / Q000601:surgery*; D016896:Treatment Outcome