Focal atrial tachycardia after pulmonary vein isolation: Noninvasive mapping with electrocardiographic imaging (ECGI)

Pitvarfibrilláció miatt végzett pulmonalis vena izolációját követően a betegek egy részénél iatrogén bal pitvari tachycardia jelentkezik. Cél: A sotalolterápia hatásosságának összehasonlítása az 1C tip. propafenonnal szemben, a postablatiós arrhythmiák kezelésében. Módszer és eredmények: A vizsgálatba 75, pitvarfibrillációban szenvedő beteget (átlagéletkor 55,4 ± 7,14 év) választottunk, akiknél a pulmonalis vénák valódi elektromos izolálását végeztük. A beavatkozás során az elektromos izolációt körkörös multipoláris katéterrel ellenőriztük. Az ablatiót követően folytattuk az antiarrhythmiás terápiát még minimum 6 hétig, de célunk annak leépítése volt. Az utánkövetést 1, majd 3 havonta tervezett, ambuláns vizsgálatok alapján végeztük. A 12. hónap végén 67 betegnél tudtuk a protokoll szerint gyűjtött adatokat elemezni. 21 betegnél jelentkezett 3 hónapot követően tartósan bal pitvari tachycardia (31,3%). 11 beteg propafenon-, 4 beteg amiodaron- és 6 beteg sotalolterápiában részesült. Az első két csoportnál sotalolterápiára váltottunk, míg az utolsó csoportnál propafenonterápiát kezdtünk. A 12. hónap végére a sotalol hatásossága 80%, a propafenon hatásossága 20% volt. Következtetések: Adataink alapján PV-izolációt követően a sotalolterápia nem hatásosabb a bal pitvari tachycardiák megelőzésében, mint a propafenon. A 3 hónapon túl fellépő postablatiós bal pitvari tachycardiák kezelésében a sotalol hatásosabb, mint az IC-csoportba tartozó propafenon.

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Triple-loop reentrant atrial tachycardia originated after pulmonary vein isolation

Journal of Interventional Cardiac Electrophysiology ◽

10.1007/s10840-016-0187-5 ◽

2016 ◽

Vol 48 (3) ◽

pp. 367-368 ◽

Cited By ~ 2

Author(s):

Masateru Takigawa ◽

Arnaud Denis ◽

Antonio Frontera ◽

Nicolas Derval ◽

Frédéric Sacher ◽

...

Keyword(s):

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Atrial Tachycardia

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Intra‐carina reentrant atrial tachycardia after pulmonary vein isolation of atrial fibrillation

Pacing and Clinical Electrophysiology ◽

10.1111/pace.14440 ◽

2022 ◽

Author(s):

Kohki Nakamura ◽

Takehito Sasaki ◽

Wataru Sasaki ◽

Yumiko Haraguchi ◽

Koki Kimura ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Atrial Tachycardia

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Atrial Fibrillation does not Occur Following Successful Catheter Ablation of Pulmonary Vein Focal Atrial Tachycardia

Heart Lung and Circulation ◽

10.1016/j.hlc.2009.05.316 ◽

2009 ◽

Vol 18 ◽

pp. S139

Author(s):

Andrew W. Teh ◽

Caroline Medi ◽

Raphael Rosso ◽

Geoffrey Lee ◽

Paul B. Sparks ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Pulmonary Vein ◽

Atrial Tachycardia ◽

Focal Atrial Tachycardia

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Left Atrial Tachycardia After Pulmonary Vein Isolation for Atrial Fibrillation

Journal of Arrhythmia ◽

10.1016/s1880-4276(05)80016-x ◽

2005 ◽

Vol 21 (5) ◽

pp. 536-541

Author(s):

Kenichi Hashimoto ◽

Ichiro Watanabe ◽

Masayoshi Kofune ◽

Sonoko Ashino ◽

Yasuo Okumura ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Left Atrial ◽

Atrial Tachycardia

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Mechanism of Atrial Tachycardia Induced by Atrial Pacing after Extensive Encircling Pulmonary Vein Isolation

Journal of Arrhythmia ◽

10.4020/jhrs.27.op11_5 ◽

2011 ◽

Vol 27 (Supplement) ◽

pp. OP11_5

Author(s):

Hideyuki Hara ◽

Masahiro Yoshinaga ◽

Yumie Matsui ◽

Satoshi Yamamoto ◽

Yuzo Akita ◽

...

Keyword(s):

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Atrial Tachycardia ◽

Atrial Pacing

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SUCCESSFUL ABLATION OF A MULTIFOCAL ATRIAL TACHYCARDIA BY PULMONARY VEIN ISOLATION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(19)33255-3 ◽

2019 ◽

Vol 73 (9) ◽

pp. 2649

Author(s):

Nilubon Methachittiphan ◽

Brandon Woodbury ◽

Anne Kroman ◽

Suresh Kumar Kulandhaisamy ◽

Nazem Akoum ◽

...

Keyword(s):

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Atrial Tachycardia ◽

Successful Ablation

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Pulmonary vein isolation using ablation index vs. CLOSE protocol with a surround flow ablation catheter

EP Europace ◽

10.1093/europace/euz244 ◽

2019 ◽

Vol 22 (1) ◽

pp. 84-89 ◽

Cited By ~ 8

Author(s):

Benjamin Berte ◽

Gabriella Hilfiker ◽

Federico Moccetti ◽

Thomas Schefer ◽

Vanessa Weberndörfer ◽

...

Keyword(s):

Atrial Fibrillation ◽

Pulmonary Vein ◽

Pulmonary Vein Isolation ◽

Contact Force ◽

Atrial Tachycardia ◽

Ablation Catheter ◽

Ablation Index ◽

First Pass ◽

Procedure Duration

Abstract Aims Pulmonary vein isolation (PVI) using ablation index (AI) incorporates stability, contact force (CF), time, and power. The CLOSE protocol combines AI and ≤6 mm interlesion distance. Safety concerns are raised about surround flow ablation catheters (STSF). To compare safety and effectiveness of an atrial fibrillation (AF) ablation strategy using AI vs. CLOSE protocol using STSF. Methods and results First cluster was treated using AI and second cluster using CLOSE. Procedural data, safety, and recurrence of any atrial tachycardia (AT) or AF >30 s were collected prospectively. All Classes 1c and III anti-arrhythmic drugs (AAD) were stopped after the blanking period. In total, all 215 consecutive patients [AI: 121 (paroxysmal: n = 97), CLOSE: n = 94 (paroxysmal: n = 74)] were included. Pulmonary vein isolation was reached in all in similar procedure duration (CLOSE: 107 ± 25 vs. AI: 102 ± 24 min; P = 0.1) and similar radiofrequency time (CLOSE: 36 ± 11 vs. AI: 37 ± 8 min; P = 0.4) but first pass isolation was higher in CLOSE vs. AI [left veins: 90% vs. 80%; P < 0.05 and right veins: 84% vs. 73%; P < 0.05]. Twelve-month off-AAD freedom of AF/AT was higher in CLOSE vs. AI [79% (paroxysmal: 85%) vs. 64% (paroxysmal: 68%); P < 0.05]. Only four patients (2%) without recurrence were on AAD during follow-up. Major complications were similar (CLOSE: 2.1% vs. AI: 2.5%; P = 0.87). Conclusion The CLOSE protocol is more effective than a PVI approach solely using AI, especially in paroxysmal AF. In this off-AAD study, 79% of patients were free from AF/AT during 12-month follow-up. The STSF catheter appears to be safe using conventional CLOSE targets.

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