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May 27, 2020JACC. Clinical electrophysiologyOpen Access

Characterization of Complex Atrial Tachycardia in Patients With Previous Atrial Interventions Using High-Resolution Mapping

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Key result

Ultra-high-resolution mapping defines atrial tachycardia mechanisms but ~46% recur despite acute ablation success.

  • n=132

Why the study?

An incomplete understanding of the mechanism of AT is a major determinant of ablation failure.

Population

132 consecutive patients with ≥1 AT excluding cavotricuspid isthmus-dependent flutter

Comparison

Ultra-high-resolution mapping with a 64-pole catheter and radiofrequency ablation

Design

Cohort study

Follow-up

Mean 13 ± 9 months

Authors

NDNicolas DervalMTMasateru TakigawaAFAntonio Frontera

Discussion

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Overview

High recurrence despite acute success warrants caution in post-intervention AT; leaves open durability of mapping-guided ablation for prospective trials.

Study Design

Type

Cohort (n=132)

Structured PICO

P
Population
132 patients (mean age 60, 23% female) with ≥1 atrial tachycardia and previous atrial interventions, evaluated with ultra-high-resolution mapping and followed for a mean of 13 months.
E
Exposure
Ultra-high-resolution mapping using a 64-pole mapping catheter followed by radiofrequency ablation.
O
Outcome
Definition of atrial tachycardia mechanism, acute ablation success, and recurrence of atrial tachycardia.

Ultra-high-resolution mapping effectively delineates complex atrial tachycardia circuits in patients with prior atrial interventions, though long-term recurrence rates remain high despite acute ablation success.

Cite This Study

Derval et al. (2020) conducted a cohort in Atrial tachycardia in patients with previous atrial interventions (n=132). Ultra-high-resolution mapping and radiofrequency ablation was evaluated on Recurrence of atrial tachycardia. Ultra-high-resolution mapping defined the mechanism in 96% of atrial tachycardias, but despite high acute ablation success, 46% of patients experienced recurrence at a mean of 13 months.

synapsesocial.com/papers/6aa457a43579aba63a0972f2https://doi.org/10.1016/j.jacep.2020.03.004
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Characterization, Mapping, and Catheter Ablation of Recurrent Atrial Tachycardias After Stepwise Ablation of Long-Lasting Persistent Atrial Fibrillation2010 · 147 citations
  2. 2Mechanism of Recurrence of Atrial Tachycardia2020 · 64 citations
  3. 3Selection of Critical Isthmus in Scar-Related Atrial Tachycardia Using a New Automated Ultrahigh Resolution Mapping System2016 · 137 citations
  4. 4Tachycardia-Mediated Cardiomyopathy Secondary to Focal Atrial Tachycardia2009 · 254 citations
  5. 5Comprehensive Multicenter Study of the Common Isthmus in Post–Atrial Fibrillation Ablation Multiple-Loop Atrial Tachycardia2018 · 57 citations