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Atrial Tachycardias Originating from the Atrial Septum:
Author(s) -
CHEN CHIENCHENG,
TAI CHINGTAI,
CHIANG CHERNEN,
YU WENCHUNG,
LEE SHIH HUANG,
CHEN YIJEN,
HSIEH MINGHSIUNG,
TSAI CHINFENG,
LEE KUNGWEI,
DING YUAN,
CHANG MAU SONG,
CHEN SHIH ANN
Publication year - 2000
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2000.tb00045.x
Subject(s) - medicine , cardiology , tachycardia , catheter ablation , ablation , radiofrequency ablation , atrial tachycardia , atrial septum , radiofrequency catheter ablation
Atrial Tachycardia. Introduction : The characteristics of atrial tachycardia (AT) have varied widely among different reports. The anatomic locations of ATs may bias the results. We propose that septal ATs and free‐wall ATs have different characteristics. Methods and Results : One hundred forty‐one patients with AT underwent electropharmacologic study, endocardial mapping, and radiofrequency ablation. Forty‐nine (34.7%) patients had septal AT originating from the anteroseptal, mid‐septal, and posteroseptal areas. Tachycardia cycle length was similar between septal AT and free‐wall AT (367 ± 46 msec vs 366 ± 58 msec, P > 0.05). More patients with septal AT required isoproterenol to facilitate induction (44.9% vs 31.5%, P < 0.05). Septal AT was more sensitive to adenosine than free‐wall AT (84.4% vs 67.8%, P < 0.05). Only posteroseptal AT showed a positive P wave in lead V, and negative P wave in all the inferior leads (II, III, aVF). Radiofrequency catheter ablation had a comparable success rate for septal AT and free‐wall AT (96% vs 95%) without impairment of AV conduction. During follow‐up of 49 ± 13 months (range 17 to 85), the recurrence rate was similar for septal AT and free‐wall AT (3.2% vs 4.6%, P = 0.08). Conclusion : Septal AT has electrophysiologic characteristics that are distinct from those of free‐wait AT. Catheter ablation of the septal AT is safe and effective.