Outcomes of radiofrequency ablation in atrial tachyarrhythmia patients following circumferential pulmonary vein isolation / 第二军医大学学报

ABSTRACT

Objective: To observe the outcomes of radiofrequency ablation in patients with atrial tachyarrhythmia (ATa) after circumferential pulmonary vein isolation (CPVI), so as to discuss the related mechanism. Methods: A total of 64 patients underwent mapping and ablation using an electroanatomic mapping system (CARTO) at a mean of (3.7±2.4) months after the first CPVA procedure. Results: A total of 78 types of ATa were mapped, including 30 (38.5%) with re-entry mechanism and 48 (61.5%) with focal mechanism. Among reentrant ATa 12 had common atrial flutter and 18 had left atrial re-entry; the reentrant circuits were related to the mitral isthmus, the anterior wall of the left atrium, and the gaps on previous encircling lines. The tachycardias were unstable in 2 patients and were not mapped. Catheter ablation was successful in 56 of the 64 patients (87.5%), and cardioversion was needed in 8 patients to achieve sinus rhythm. During a mean follow-up of 13-21(16.5±2.9) months, 60 (93.8%) cases no longer had ATa. Conclusion: ATa after CPVA can have macro-reentrant and focal mechanisms. These arrhythmias can be successfully mapped and ablated with an electroanatomic mapping system.