Ablation of atrial tachycardia in the setting of prior mitral valve surgery.
Minerva Cardiol Angiol
; 69(1): 94-101, 2021 02.
Article
en En
| MEDLINE
| ID: mdl-33146481
ABSTRACT
BACKGROUND:
Data regarding catheter ablation of post-surgical atrial tachycardia occurring after mitral valve surgery are scarce. Through a search of the literature, this study aimed to assess the feasibility of catheter ablation and the characteristics of atrial arrhythmias ablated in these patients.METHODS:
Studies assessing the main procedure parameters and the electrophysiologic findings of the investigated atrial tachycardia were selected. The electrophysiologic mechanism (focal vs. re-entrant arrhythmias), site of arrhythmia origin (left atrium vs. right atrium) and their anatomic correlation with specific surgical access and/or prior Cox-Maze IV procedure were all addressed.RESULTS:
Eleven studies including 206 patients undergoing catheter ablation of 297 post-surgical arrhythmia morphologies occurring after mitral valve surgery were considered. Major complications were observed in 2 patients only (0.9%). Restoration of sinus rhythm was achieved in 96% of patients. Macro-reentrant arrhythmia was mostly observed (90.4%) with a non-negligible proportion of focal arrhythmia (9.6%). Left-sided arrhythmia was common (54.4%,) but cavotricuspid isthmus-dependent arrhythmia was frequently reported (33%). Although specific atriotomies showed trends towards peculiar locations of the investigated arrhythmia, Cox-Maze IV procedure was the only independent predictor for left-sided arrhythmia (OR=17.3; 95% CI 7.2-41.2; P<0.0001).CONCLUSIONS:
Catheter ablation of post-surgical arrhythmia occurring after mitral valve surgery is feasible, and, in this setting, the vast majority of the arrhythmia morphologies are based on macro-reentry and in about one third of cases show cavotricuspid isthmus-dependent arrhythmia. Prior Cox-Maze-IV associated with mitral valve surgery is an independent predictor of left-sided arrhythmia possibly due to non-transmural surgical lesions.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Taquicardia Supraventricular
/
Ablación por Catéter
/
Procedimientos Quirúrgicos Cardíacos
Tipo de estudio:
Prognostic_studies
Idioma:
En
Revista:
Minerva Cardiol Angiol
Año:
2021
Tipo del documento:
Article