The role of noncoronary cusp ablation approach in the treatment of perinodal atrial tachycardias.
BACKGROUND
Ablation in the noncoronary aortic cusp (NCC) potentially has a role in the treatment of perinodal atrial tachycardias (ATs). The objective of the study was to characterize clinical and electrophysiological properties of perinodal ATs between two groups of requiring and not requiring NCC ablation.


METHODS
A total of 113 patients with focal ATs who underwent electrophysiologic study and radiofrequency catheter ablation were enrolled in the study. The clinical and electrophysiological characteristics of ATs that need and not need NCC ablation were compared.


RESULTS
Totally 20 cases were revealed to have the focal ATs located in the perinodal area. Among them, only five cases (25%) warrant ablation in the NCC, whereas the remainder could be successfully eliminated by ablation from the endocardial right atrium at the perinodal region. There were no clinical and electrophysiological clues observed to have the potential to predict the true original site, including the activation mode, the three-dimensional mapping characteristics of earliest activation site in the right atrium, as well as the time of termination during the ablation in the perinodal area.


CONCLUSIONS
Approximately, one-fourth of the perinodal ATs warrant ablation in the NCC. However, no clinical and electrophysiological clues could predict the potential site of the perinodal ATs.
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Weizhu
W
Ju
Minglong
M
Chen
Bing
B
Yang
Hongwu
H
Chen
Fengxiang
F
Zhang
Mingfang
M
Li
Jinbo
J
Yu
Kejiang
K
Cao
D001011:Aorta / Q000601:surgery*; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome