Catheter ablation of atrial macroreentry tachycardia achieved an atrial tachyarrhythmia-free outcome in 95% of patients with right AMRT and 82% with left AMRT over a 37-month follow-up.
Observational (n=33)
Does electroanatomical mapping and catheter ablation improve atrial tachyarrhythmia-free clinical outcome in patients with AMRT without obvious structural heart disease or previous intervention?
Catheter ablation of atrial macroreentry tachycardia in patients without structural heart disease or prior interventions is highly successful, with most circuits related to electrically silent areas.
INTRODUCTION: Atrial macroreentry tachycardia (AMRT) in patients without obvious structural heart disease or previous surgical or catheter intervention has not been characterized in detail. METHODS AND RESULTS: Electroanatomical mapping and ablation of right or left AMRT were performed in 33 patients. Right atrial central conduction obstacle was formed by an electrically silent area (ESA) in 15 (68%) patients and by a line of double potentials (DPs) in seven (32%) patients. Left atrial ESAs were found in all 11 patients with the left AMRT. Reentry circuit was reconstructed in 19 (86%) patients with right AMRT and seven (64%) patients with left AMRT. Of the ESA-related right AMRT, eight (50%) were double-loop reentry circuits utilizing a narrow critical isthmus within the ESA and eight (50%) were single-loop reentry circuits with a critical isthmus bounded by ESA and either ostium of the vena cava. Single-loop DP-related AMRTs had the critical isthmus between the DP line and the ostium of the inferior vena cava (IVC). Left AMRTs included a variety of single-, double-, or triple-loop reentry circuits and their critical isthmuses. During the 37 +/- 15 month follow-up, atrial tachyarrhythmia-free clinical outcome was achieved in 21 (95%) patients (18 patients, 82%, without antiarrhythmic drugs) with the right AMRT and in nine (82%) patients (six patients, 55%, without antiarrhythmic drugs) with the left AMRT. CONCLUSION: The majority of right and left AMRTs were related to the presence of ESA. Ablation can be successful with a favorable risk of atrial tachyarrhythmia recurrence.
Fiala et al. (Wed,) conducted a observational in Atrial macroreentry tachycardia without obvious structural heart disease or previous intervention (n=33). Electroanatomical mapping and catheter ablation was evaluated on Atrial tachyarrhythmia-free clinical outcome. Catheter ablation of atrial macroreentry tachycardia achieved an atrial tachyarrhythmia-free outcome in 95% of patients with right AMRT and 82% with left AMRT over a 37-month follow-up.
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