Electroanatomic mapping and radiofrequency catheter ablation of marcro-reentry atrial tachycardia / 中国介入心脏病学杂志

ABSTRACT

Objective To explore the mechanism of macro-reentry atrial tachycardia and to guide catheter ablation using electroanatomic mapping system in 3 patients.Methods Three patients(two females),aged 51?12 years,with atrial tachycardia were included.The mean history of symptom was 19?11 years.Conventional electrophysiological study was performed to determine the location of atrial tachycardia before the three dimensional geometry reconstruction.After voltage and activation maps were constructed,the mechanism of tachycardia was analyzed and the slow conduction areas(critical isthmus) were verified.Radiofrequency energy was delivered using irrigated-tip catheter.Results Though there was no evidence to suggest structural heart diseases,scar areas were found in the mapped atria in all the three cases.The mechanism of atrial tachycardia was found to be counter-clockwise macro-reentry around tricuspid valve,counter-clockwise macro-reentry around superior vena cava,and figure "8" reentry in left atria in the 3 patients respectively.The respective critical isthmus was found to be between the lateral scar and tricuspid valve,the lateral scar and superior vena cava,and two scars on the left atria roof.Ablation in the critical isthmus terminated all tachycardia.There were no atrial tachycardia recurrence during a follow-up of 9-10 months.Conclusion The substrate and electrophysiological mechanism of macro-reentry atrial tachycardia could be identified clearly,and navigation ablation could be performed effectively under the guidence of electroanatomic mapping.