Premium
Electrophysiological and clinical characteristics of catheter ablation for isolated left side atrial tachycardia over a 10‐year period
Author(s) -
Vicera Jennifer J. B.,
Lin YennJiang,
Lin ChinYu,
Lu DaiYin,
Chang ShihLin,
Lo LiWei,
Chung FaPo,
Chao TzeFan,
Hu YuFeng,
Tuan TaChuan,
Liao JoNan,
Chen YunYu,
Sukardi Rubiana,
Salim Simon,
Wu ChengI,
Liu ChihMin,
Hoang QuangMinh,
Ba Vu Van,
Huang TingChun,
Chuang ChiehMao,
Chen ChunChao,
Chin ChyeGen,
Kuo Ling,
Chen ShihAnn
Publication year - 2019
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/jce.13945
Subject(s) - medicine , cardiology , atrial fibrillation , atrial tachycardia , catheter ablation , ejection fraction , pulmonary vein , ablation , tachycardia , atrial flutter , heart failure
Abstract Aims Most left atrial tachycardia (LAT) is associated with atrial fibrillation (AF). The clinical and electrophysiological characteristics and outcomes of LAT without AF have not been investigated. This study sought to determine the long‐term ablation outcomes and predictors of recurrence of isolated LAT. Methods This is a single‐center study of consecutive patients with isolated LAT. Atrial arrhythmia recurrence was determined from follow‐up records of patients who underwent LAT ablation from 2008 to 2017. Clinical and electrophysiologic characteristics associated with atrial arrhythmia recurrence were identified. Results A total of 50 patients (53 ± 19 years, 46% male) with 59 LAT (1.16 ± 0.47 per patient) were enrolled. Over a mean follow‐up of 37 ± 33 months, atrial arrhythmia recurrence occurred in 22 (44%) patients, 11 with atrial tachycardia (AT) only, five with AF only, and six with concurrent AT and AF. The incidence of pulmonary vein (PV) origins increased significantly in the repeat procedure ( P = 0.036). Multivariate analysis identified left ventricular ejection fraction (LVEF) as the only predictor of any atrial arrhythmia recurrence and LAT recurrence, while smoking and identified macroreentrant LAT in the index procedure predicted AF recurrence. Conclusion This study demonstrated a higher rate of atrial arrhythmia recurrence, including AF, among patients with initially isolated LAT. A lower LVEF predicted any atrial arrhythmia and LAT recurrence, whereas smoking and index macroreentrant AT mechanism predicted long‐term AF. PV ATs were frequently observed in recurrent patients irrespective of index procedure origin.