Volume 34, Issue 4 pp. 391-397

Noncavotricuspid Isthmus-Dependent Right Atrial Tachycardia after Paroxysmal Atrial Fibrillation Ablation

WEIZHU JU M.D.,

WEIZHU JU M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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BING YANG M.D.,

BING YANG M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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HONGWU CHEN M.D.,

HONGWU CHEN M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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FENGXIANG ZHANG M.D.,

FENGXIANG ZHANG M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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LISHANG ZHAI M.D.,

LISHANG ZHAI M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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KEJIANG CAO M.D.,

KEJIANG CAO M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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MINGLONG CHEN M.D.,

MINGLONG CHEN M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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WEIZHU JU M.D.,

WEIZHU JU M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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BING YANG M.D.,

BING YANG M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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HONGWU CHEN M.D.,

HONGWU CHEN M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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FENGXIANG ZHANG M.D.,

FENGXIANG ZHANG M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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LISHANG ZHAI M.D.,

LISHANG ZHAI M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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KEJIANG CAO M.D.,

KEJIANG CAO M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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MINGLONG CHEN M.D.,

MINGLONG CHEN M.D.

Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China

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First published: 22 November 2010

https://doi.org/10.1111/j.1540-8159.2010.02970.x

Citations: 2

Address for reprints: Minglong Chen, M.D., Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China. Fax: 0086-25-8378-1867; e-mail: [email protected]

Dr. Ju and Dr. Yang contributed equally to this work.

Relationship with Industry Policy: None

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Abstract

Background: Atrial tachycardia (AT) is commonly encountered after atrial fibrillation (AF) ablation. But no study exclusively on noncavotricuspid isthmus-dependent right AT (NCTI-RAT) post-AF ablation has been reported. The present study aims to describe its prevalence, electrophysiological mechanisms, and ablation strategy and to further discuss its relationship with AF.

Methods: From July 2006 to November 2009, 350 consecutive patients underwent catheter ablation for paroxysmal AF. A total of seven patients (2.0%) developed NCTI-RAT after left atrium ablation for AF. In these highly selected patients (two male, mean age 54 ± 11 years, mean left atrium diameter of 34 ± 7 cm), all had circumferential pulmonary vein isolation in their initial procedures and three of them had additional complex fractionated electrograms ablation in the left atrium and the coronary sinus.

Results: Totally, nine NCTI-RATs were mapped and successfully ablated in the right atrium with a mean cycle length of 273 ± 64 ms in seven patients. Five ATs in three patients were electrophysiologically proved to be macroreentry and the remaining four were focal activation. All the ATs were successfully abolished by catheter ablation. After a mean follow-up of 29 ± 15 months post-AT ablation, all patients were free of AT and AF off antiarrhythmic drugs.

Conclusions: NCTI-RAT is relatively less common post-AF ablation. Totally, 2.0% of paroxysmal AF patients were revealed to have NCTI-RAT. (PACE 2011; 34:391–397)

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Volume34, Issue4

April 2011

Pages 391-397

Noncavotricuspid Isthmus-Dependent Right Atrial Tachycardia after Paroxysmal Atrial Fibrillation Ablation

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Noncavotricuspid Isthmus-Dependent Right Atrial Tachycardia after Paroxysmal Atrial Fibrillation Ablation

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