Among patients with perinodal focal atrial tachycardias, 25% required ablation in the noncoronary aortic cusp, with no clinical or electrophysiological clues predicting the true original site.
Observational (n=113)
Do clinical and electrophysiological properties predict the need for noncoronary aortic cusp (NCC) ablation in patients with perinodal atrial tachycardias?
Approximately 25% of perinodal atrial tachycardias require ablation in the noncoronary aortic cusp, but there are currently no reliable clinical or electrophysiological predictors to identify these cases prior to ablation.
Absolute Event Rate: 25% vs 75%
BACKGROUND: Ablation in the noncoronary aortic cusp (NCC) potentially has a role in the treatment of perinodal atrial tachycardias (ATs). The objective of the study was to characterize clinical and electrophysiological properties of perinodal ATs between two groups of requiring and not requiring NCC ablation. METHODS: A total of 113 patients with focal ATs who underwent electrophysiologic study and radiofrequency catheter ablation were enrolled in the study. The clinical and electrophysiological characteristics of ATs that need and not need NCC ablation were compared. RESULTS: Totally 20 cases were revealed to have the focal ATs located in the perinodal area. Among them, only five cases (25%) warrant ablation in the NCC, whereas the remainder could be successfully eliminated by ablation from the endocardial right atrium at the perinodal region. There were no clinical and electrophysiological clues observed to have the potential to predict the true original site, including the activation mode, the three-dimensional mapping characteristics of earliest activation site in the right atrium, as well as the time of termination during the ablation in the perinodal area. CONCLUSIONS: Approximately, one-fourth of the perinodal ATs warrant ablation in the NCC. However, no clinical and electrophysiological clues could predict the potential site of the perinodal ATs.
Ju et al. (Tue,) conducted a observational in Perinodal atrial tachycardias (n=113). Noncoronary aortic cusp (NCC) ablation vs. Endocardial right atrium ablation was evaluated on Successful elimination of perinodal atrial tachycardia. Among patients with perinodal focal atrial tachycardias, 25% required ablation in the noncoronary aortic cusp, with no clinical or electrophysiological clues predicting the true original site.