|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 1993; 21:910-917 © 1993 by the American College of Cardiology Foundation |
Department of Medicine, Georgetown University Hospital, Washington, D.C. 20007.
OBJECTIVES. Although ectopic atrial tachycardia is infrequent, it can be an important clinical challenge. We sought to define an alternative therapeutic approach to this refractory problem. BACKGROUND. Radiofrequency energy catheter ablation has been used to treat a variety of ventricular and supraventricular arrhythmias but has not been proved efficacious in the management of ectopic atrial tachycardia. METHODS. Ten patients (14 to 47 years of age) referred with refractory ectopic atrial tachycardia were studied. Mapping techniques included identification of earliest atrial activation, confirmation of concordance of P wave configuration during spontaneous tachycardia and pacing from the ablation catheter, and paced activation sequence mapping. The paced activation sequence mapping compared the activation sequence at multiple atrial sites during spontaneous tachycardia with that recorded during pacing from the ablation catheter. The catheter was steered to a point where pacing reproduced the spontaneous activation sequence. RESULTS. Foci were right atrial in eight patients and left atrial in two. In 8 of 10 patients, 514 +/- 97 (SE) J and 5.7 +/- 2.3 (SD) J radiofrequency energy applications ablated the ectopic focus. Seven of these eight patients presented with one focus and one had two discrete and stable foci. Ablation was unsuccessful in two patients with multiple foci. No complications occurred. An arrhythmia focus recurred in two patients and one patient underwent successful repeat ablation. The other patient was managed medically. All seven patients with successful ablation are symptom free after 6.5 +/- 3.8 months. CONCLUSIONS. Our preliminary experience suggests that with the use of both paced activation sequence mapping and standard techniques, radiofrequency ablation of ectopic atrial tachycardia may be a safe and effective form of therapy.
This article has been cited by other articles:
|
|
 |
|
  X. Freixa, A. Berruezo, L. Mont, S. Magnani, B. Benito, J. M. Tolosana, P. Perafan, D. Tamborero, and J. Brugada Characterization of focal right atrial appendage tachycardia Europace, January 1, 2008; 10(1): 105 - 109. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Higa, C.-T. Tai, Y.-J. Lin, T.-Y. Liu, P.-C. Lee, J.-L. Huang, M.-H. Hsieh, Y. Yuniadi, B.-H. Huang, S.-H. Lee, et al. Focal Atrial Tachycardia: New Insight From Noncontact Mapping and Catheter Ablation Circulation, January 6, 2004; 109(1): 84 - 91. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Kistler, P. Sanders, S. P. Fynn, I. H. Stevenson, A. Hussin, J. K. Vohra, P. B. Sparks, and J. M. Kalman Electrophysiological and Electrocardiographic Characteristics of Focal Atrial Tachycardia Originating From the Pulmonary Veins: Acute and Long-Term Outcomes of Radiofrequency Ablation Circulation, October 21, 2003; 108(16): 1968 - 1975. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. F. Marrouche, A. SippensGroenewegen, Y. Yang, S. Dibs, and M. M. Scheinman Clinical and electrophysiologic characteristics of left septal atrial tachycardia J. Am. Coll. Cardiol., September 18, 2002; 40(6): 1133 - 1139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. Wetzel, G. Hindricks, P. Schirdewahn, A. Dorszewski, A. Fleck, F. Heinke, and H. Kottkamp A stepwise mapping approach for localization and ablation of ectopic right, left, and septal atrial foci using electroanatomic mapping Eur. Heart J., September 1, 2002; 23(17): 1387 - 1393. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Frey, G. Kreiner, M. Gwechenberger, and H. D. Gossinger Ablation of atrial tachycardia originating from the vicinity of the atrioventricular node: significance of mapping both sides of the interatrial septum J. Am. Coll. Cardiol., August 1, 2001; 38(2): 394 - 400. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. T. Kim, A. C. Lai, C. Hwang, L.-T. Fan, H. S. Karagueuzian, P.-S. Chen, and M. C. Fishbein The ligament of Marshall: a structural analysis in human hearts with implications for atrial arrhythmias J. Am. Coll. Cardiol., October 1, 2000; 36(4): 1324 - 1327. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Zrenner, G. Ndrepepa, M. Schneider, M. Karch, F. Hofmann, A. Schomig, and C. Schmitt Computer-assisted animation of atrial tachyarrhythmias recorded with a 64-electrode basket catheter J. Am. Coll. Cardiol., December 1, 1999; 34(7): 2051 - 2060. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. N. Doshi, T.-J. Wu, M. Yashima, Y.-H. Kim, J. J. C. Ong, J.-M. Cao, C. Hwang, P. Yashar, M. C. Fishbein, H. S. Karagueuzian, et al. Relation Between Ligament of Marshall and Adrenergic Atrial Tachyarrhythmia Circulation, August 24, 1999; 100(8): 876 - 883. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Schmitt, B. Zrenner, M. Schneider, M. Karch, G. Ndrepepa, I. Deisenhofer, S. Weyerbrock, J. Schreieck, and A. Schomig Clinical Experience With a Novel Multielectrode Basket Catheter in Right Atrial Tachycardias Circulation, May 11, 1999; 99(18): 2414 - 2422. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Morady Radio-Frequency Ablation as Treatment for Cardiac Arrhythmias N. Engl. J. Med., February 18, 1999; 340(7): 534 - 544. [Full Text] [PDF]
|
|
|
|
|
|
K. C. Man, K.K. Chan, P. Kovack, R. Goyal, F. Bogun, M. Harvey, E. Daoud, S. A. Strickberger, and F. Morady Spatial Resolution of Atrial Pace Mapping as Determined by Unipolar Atrial Pacing at Adjacent Sites Circulation, September 15, 1996; 94(6): 1357 - 1363. [Abstract] [Full Text]
|
|
|
|
|
|
L. I. Ganz and P. L. Friedman Supraventricular Tachycardia N. Engl. J. Med., January 19, 1995; 332(3): 162 - 173. [Full Text] [PDF]
|
|
|
|
 |
|
 CATHETER ABLATION FOR REFRACTORY ATRIAL ARRHYTHMIAS Journal Watch (General), April 13, 1993; 1993(413): 5 - 5. [Full Text]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
