Atrial tachycardias following circumferential pulmonary vein ablation: observations during catheter ablation |
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Authors: | Marc Horlitz Philipp Schley Dong-In Shin Beatrice Tonnellier Hartmut Gülker |
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Affiliation: | 1.Kooperatives K?lner Herzzentrum beidseits des Rheins, Abteilung für klinische Elektrophysiologie und Rhythmologie,Krankenhaus Porz am Rhein gGmbH,Cologne,Germany;2.Praxis für Kardiologie und Elektrophysiologie,Viersen,Germany;3.Helios Klinikum Wuppertal,Universit?t Witten/Herdecke, Herzzentrum, Medizinische Klinik 3,Wuppertal,Germany |
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Abstract: | Circumferential pulmonary vein ablation performing linear lesions around the ostia of the pulmonary veins has been shown to be effective for the treatment of atrial fibrillation. During the follow-up period, persistent atrial tachycardia may occur as a proarrhythmic complication. Only little information is available about the underlying mechanism. In our study, atrial tachycardia following circumferential pulmonary vein ablation was identified in 13 out of 84 consecutive patients (15.5%), as a transient appearance in four and with recurrences for more than 3 months in nine patients (10.7%). Electrophysiological study and ablation was performed in eight cases, revealing common atrial flutter in two, a focal origin secondary to conduction recovery from the pulmonary vein to the left atrium in two and macro reentrant left atrial flutter in four patients. The electrophysiological characteristics demonstrated by electroanatomic activation mapping (CARTO™) and consecutive ablation therapy with a 100% success rate are described and discussed with regard to the literature. |
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Keywords: | atrial fibrillation atrial tachycardia electroanatomic mapping circumferential pulmonary vein ablation |
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