Atrial overdrive pacing localized the focus of atrial tachycardia, with the post-pacing interval minus tachycardia cycle length being 11 +/- 8 msec at the successful ablation site (P<0.001).
Observational (n=24)
Does atrial overdrive pacing help localize the focus of focal atrial tachycardia?
Atrial overdrive pacing is a clinically useful maneuver to localize the focus of focal atrial tachycardia, as the difference between the post-pacing interval and tachycardia cycle length directly correlates with proximity to the focus.
Absolute Event Rate: 11% vs 131%
p-value: p=< 0.001
BACKGROUND: Although focal atrial tachycardias cannot be entrained, we hypothesized that atrial overdrive pacing (AOP) can be an effective adjunct to localize the focus of these tachycardias at the site where the post-pacing interval (PPI) is closest to the tachycardia cycle length (TCL). METHODS: Overdrive pacing was performed in nine patients during atrial tachycardia, and in a comparison group of 15 patients during sinus rhythm. Pacing at a rate slightly faster than atrial tachycardia in group 1 and sinus rhythm in group 2 was performed from five standardized sites in the right atrium and coronary sinus. The difference between the PPI and tachycardia or sinus cycle length (SCL) was recorded at each site. The tachycardia focus was then located and ablated in group 1, and the atrial site with earliest activation was mapped in group 2. RESULTS: In both groups the PPI-TCL at the five pacing sites reflected the distance from the AT focus or sinus node. In group 1, PPI-TCL at the successful ablation site was 11 +/- 8 msec. In group 2, PPI-SCL at the site of earliest atrial activation was 131 +/- 37 msec (P < 0.001 for comparison). In groups 1 and 2, calculated values at the five pacing sites were proportional to the distance from the AT focus or sinus node, respectively. CONCLUSIONS: The PPI-TCL after-AOP of focal atrial tachycardia has a direct relationship to proximity of the pacing site to the focus, and may be clinically useful in finding a successful ablation site.
Mohamed et al. (Wed,) conducted a observational in Focal atrial tachycardia (n=24). Atrial overdrive pacing vs. Sinus rhythm was evaluated on Difference between post-pacing interval and tachycardia or sinus cycle length at the site of earliest activation or successful ablation (p=< 0.001). Atrial overdrive pacing localized the focus of atrial tachycardia, with the post-pacing interval minus tachycardia cycle length being 11 +/- 8 msec at the successful ablation site (P<0.001).