title: Lower rate of left atrial tachycardia after pulmonary vein isolation with PVAC versus irrigated-tip circumferential antral ablation.
abstract: Left atrial tachycardias (LAT) occur in about 5% of patients after irrigated-tip circumferential antral (CA) pulmonary vein isolation (PVI). They may cause debilitating symptoms in the patient and may be very difficult to treat.
  
  
  
  To assess the incidence of LAT after PVI with the multielectrode phased-radiofrequency pulmonary vein ablation catheter (PVAC) compared to circumferential antral PVI with an irrigated-tip catheter.
  
  
  
  We analyzed data from our ablation database. A total of 150 patients who underwent their first PVI with the PVAC system and 300 patients who underwent their first PVI with irrigated-tip circumferential antral (CA) radiofrequency ablation were matched by age and sex, as well as by type of atrial fibrillation.
  
  
  
  Of 150 PVAC patients, only 1 patient (0.7%) developed LAT during mean follow-up of 21 ± 14 months. The mechanism was macroreentry and the patient underwent successful ablation at our institution. Eleven of 300 irrigated-tip CA PVI patients (3.7%) developed LAT during mean follow-up of 22 ± 14 months and subsequently underwent ablation (P = .05).
  
  
  
  LAT occurs more frequently after irrigated-tip CA PVI compared to single-shot-device ablation with PVAC. Apart from being less technically demanding, lower incidence of LAT may influence choice of ablation technology.
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany. Electronic address: wasmerk@ukmuenster.de.
authors.forename: Kristina
authors.initials: K
authors.lastname: Wasmer
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Krüsemann
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Patrick
authors.initials: P
authors.lastname: Leitz
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Fatih
authors.initials: F
authors.lastname: Güner
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Pott
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Zellerhoff
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Dechering
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Köbe
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Lange
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Eckardt
authors.affiliation: Division of Clinical and Experimental Electrophysiology, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors.forename: Gerold
authors.initials: G
authors.lastname: Mönnig
mesh_terms: D000792:Angiography; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation / Q000295:instrumentation*; D015716:Electrocardiography, Ambulatory; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006329:Heart Conduction System / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000000981:diagnostic imaging / Q000601:surgery*; D013617:Tachycardia, Supraventricular / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D007507:Therapeutic Irrigation / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Circumferential ablation; Left atrial tachycardia; PVAC ablation; Pulmonary vein isolation