title: Ablation of atrial tachycardia occurring after catheter ablation of atrial fibrillation in patients with corrected rheumatic valve disease.
abstract: OBJECTIVE
  The purpose of this study is to investigate the mechanism and the effectiveness of ablation of atrial tachycardia (AT) recurring after atrial fibrillation (AF) ablation in patients with rheumatic valvular disease (RVD) and mitral valve prosthesis.
  
  
  METHODS
  Twenty-eight consecutive patients with RVD and mitral valve prosthesis and a 1:2 matched control group (n = 56) without RVD underwent reablation for recurrent AT after catheter ablation of long-standing persistent AF.
  
  
  RESULTS
  Macro- or localized reentrant ATs were identified in 47 (87 %) of 54 ATs from RVD group and in 65 (78.3 %) of 83 ATs from control. There were more average ATs per patient in the RVD group than in the control (1.9 ± 0.6 vs.1.5 ± 0.6, P = 0.002). The proportion of patients having ≥2 ATs was significantly higher in the RVD group than in the control (78.6 vs.41.1 %, P = 0.001). In the RVD group, ATs were successfully ablated in 44 (81.5 %) of 54 ATs and terminated in 18 (64.3 %) of 28 patients. In the control, ATs were successfully ablated in 72 (86.7 %) of 83 ATs and terminated in 45 (80.4 %) of 56 patients, P = 0.54 and 0.10, respectively. After a mean follow-up of 13 months, 16 patients (57.1 %) from the RVD group and 45 patients (80.4 %) from the control were free of further recurrence, P = 0.02.
  
  
  CONCLUSIONS
  Macro- or localized reentries were the predominant type of recurrent AT after long-standing persistent AF ablation in both the RVD and the control groups. Compared with patients without RVD, patients with RVD had more average number of ATs and had higher probability of further recurrence despite the similar acute effectiveness of reablation.
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.
authors.forename: Xin-Hua
authors.initials: XH
authors.lastname: Wang
authors.forename: Cong-Xin
authors.initials: CX
authors.lastname: Huang
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
authors.forename: Hai-Feng
authors.initials: HF
authors.lastname: Shi
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Tan
authors.forename: Wei-Feng
authors.initials: WF
authors.lastname: Jiang
authors.forename: Yuan-Long
authors.initials: YL
authors.lastname: Wang
mesh_terms: D000925:Anticoagulants / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D016022:Case-Control Studies; D017115:Catheter Ablation / Q000379:methods*; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence; D012214:Rheumatic Heart Disease / Q000503:physiopathology* / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D000925:Anticoagulants