Radiofrequency ablation of focal atrial tachycardia originating from the septal mitral annulus achieved long-term success in 92.3% (12 of 13) of patients over 23 ± 6 months with no complications.
Observational (n=13)
Is radiofrequency ablation safe and effective for patients with focal atrial tachycardia originating from the septal mitral annulus?
Radiofrequency ablation via a transseptal or retrograde aortic approach is a safe and effective treatment for focal atrial tachycardia originating from the septal mitral annulus.
AIMS: This study sought to investigate electrocardiographic characteristics, electrophysiological features, and radiofrequency ablation in patients with focal atrial tachycardia (AT) originating from the septal mitral annulus. METHODS AND RESULTS: In 13 patients with AT originating from the septal mitral annulus, activation mapping was performed to identify the earliest activation site. Successful ablation was performed through either a transseptal (n = 12) or a retrograde aortic approach (n = 1). As confirmed by electrogram recordings, fluoroscopy, and three-dimensional (3D) mapping, successful ablation sites were located in the anterior paraseptal, mid- to anteroseptal, and posterior septal mitral annulus in eight, three, and two patients, respectively. Foci for all locations demonstrated a negative/positive appearance in lead V1. Mapping in the right atrium demonstrated that the earliest right atrial activation was near the septum (His-bundle region or proximal coronary sinus). The electrograms at the successful ablation sites were fractionated in 9 patients, and presented with an atrial:ventricular ratio of <1 in all 13 patients. There were no complications in any patients and long-term success was achieved in 12 of 13 patients during the 23 ± 6 months following ablation. CONCLUSION: The area surrounding the septal mitral annulus, most commonly the anterior paraseptal, is an unusual, but important site of origin for focal AT, which is associated with a distinctive P-wave morphology and atrial endocardial activation sequence. Radiofrequency ablation of AT originating from the septal mitral annulus, through either a transseptal or a retrograde aortic approach appears to be safe and effective.
Wang et al. (Wed,) conducted a observational in Focal atrial tachycardia originating from the septal mitral annulus (n=13). Radiofrequency ablation was evaluated on Long-term success. Radiofrequency ablation of focal atrial tachycardia originating from the septal mitral annulus achieved long-term success in 92.3% (12 of 13) of patients over 23 ± 6 months with no complications.