Characteristics and Ablation Outcomes of Atrial Tachycardia in Patients with Prior Cardiac Surgery vs. Spontaneous Scars: Where Are the Differences?

Figures

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  Figure 1. Schematic diagram of different ablation position of reentrant AT in patients with right atrial scars. (A): a diagram of AFL, which is a reentrant tachycardia rotating around TA in clockwise or counterclockwise direction; linear ablation is performed from TA to IVC. (B–E): diagrams of SMAT, which are reentrant tachycardias circuiting around atrial scars; linear ablation is performed from scar to IVC in (B), scar to TA in (C), scar to SVC in (D) and between scars in (E). AFL: cavo-tricuspid isthmus dependent atrial flutter; SMAT: scar-mediated atrial tachycardia; IVC: inferior vena cava; TA: tricuspid annulus; SVC: superior vena cava.

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  Figure 2. Quantitative analysis of ATs in patients of PCS group and SS group. Compared with PCS group, larger proportion of patients in SS group had multiple ATs. PCS: prior cardiac surgery; SS: spontaneous scar.

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  Figure 3. Qualitative analysis of ATs in patients of PCS group and SS group. SMAT was the most common AT in SS group, with significantly higher occurrence than in PCS group; AFL was the most common AT in PCS group, whereas there were no significant differences between 2 groups. FAT was rare, but the SS group compared with PCS group had higher occurrence of FAT. SVC/IVC-reentrant tachycardias were classified as “others”; 1 patient in PCS group had SVC-reentrant tachycardia and 1 patient in SS group had IVC-reentrant tachycardia. AFL: cavo-tricuspid isthmus dependent atrial flutter; SMAT: scar-mediated reentrant atrial tachycardia. * p < 0.05. *** p < 0.001. ns: not significant.

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  Figure 4. Ablation positions of 2 groups. PCS: prior cardiac surgery; SS: spontaneous scar; CTI: cavo-tricuspid isthmus; IVC: inferior vane cava; TA: tricuspid annulus; SVC: superior vane cava. * p < 0.05. ** p < 0.01. ns: not significant.