Mapping and ablation of left atrial roof-dependent tachycardias using an ultra-high resolution mapping system.
BMC Cardiovasc Disord
; 22(1): 57, 2022 02 16.
Article
in En
| MEDLINE
| ID: mdl-35172730
ABSTRACT
BACKGROUND:
Left atrial roof-dependent tachycardias (LARTs) are common macroreentrant atrial tachycardias (ATs). We sought to characterize clinical LARTs using an ultra-high resolution mapping system.METHODS:
This study included 22 consecutive LARTs in 21 patients who underwent AT mapping/ablation using Rhythmia systems.RESULTS:
Three, 13, 4, and 2 LART patients were cardiac intervention naïve (Group-A), post-roof line ablation (Group-B), post-atrial fibrillation ablation without linear ablation (Group-C), and post-cardiac surgery (Group-D), respectively. The mean AT cycle length was 244 ± 43 ms. Coronary sinus activation was proximal-to-distal or distal-to-proximal in 16 (72.7%) ATs. The activation map revealed 13 (59.1%) clockwise and 9 (40.9%) counter-clockwise LARTs. A 12-lead synchronous isoelectric interval was observed in 10/19 (52.6%) LARTs. The slow conduction area was identified on the LA roof, anterior/septal wall, and posterior wall in 18, 6, and 2 ATs, respectively. Twenty concomitant ATs among 13 procedures were also eliminated, and peri-mitral AT coexisted in 7 of 9 non-group-B patients. In group-B, the conduction gap was predominantly located on the mid-roof. Sustained LARTs were terminated by a single application and linear ablation in 6 (27.3%) and 9 (40.9%), while converting to other ATs in 7 (31.8%) LARTs. Complete linear block was created without any complications in all, however, ablation at the mid-posterior wall was required to achieve block in 4 (18.2%) procedures. During 14.0 (6.5-28.5) months of follow-up, 17 (81.0%) and 19 (90.5%) patients were free from any atrial tachyarrhythmias after single and last procedures.CONCLUSIONS:
The LART mechanisms were distinct in individual patients, and elimination of all concomitant ATs was required for the management.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tachycardia, Supraventricular
/
Action Potentials
/
Catheter Ablation
/
Electrophysiologic Techniques, Cardiac
/
Heart Atria
Type of study:
Diagnostic_studies
/
Prognostic_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
BMC Cardiovasc Disord
Journal subject:
ANGIOLOGIA
/
CARDIOLOGIA
Year:
2022
Document type:
Article
Affiliation country: