Mechanism and re-ablation strategy for postablation atrial tachyarrhythmia in atrial fibrillation patients
10.3321/j.issn:0253-3758.2008.11.012
- VernacularTitle:心房颤动射频消融术后继发房性心律失常的机制和对策
- Author:
Chen-Yang JIANG
1
;
Zu-Wen ZHANG
;
Xia SHENG
;
You-Qi FAN
;
Hui-Qin FENG
;
Yong SUN
;
Bin-Quan ZHOU
;
Hong HE
;
Duan LU
;
Guo-Sheng FU
Author Information
1. 浙江大学医学院附属邵逸夫医院
- Keywords:
Atrial fibrillation;
Catheter ablation:Pulmonary veins
- From:
Chinese Journal of Cardiology
2008;36(11):1009-1012
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the mechanism and re-ablation strategy of recurrent atrial tachyarrhythmia (ATA) following circumferential ablation of pulmonary veins (PV) in patients with atrial fibrillation (AF).Methods Fifteen patients with recurrent ATA following first AF ablation procedure were included in this study.Under CARTO guidance,PVs were remapped and ablated subsequently for relapse of left atrium to PV conduction.The whole atrium was then remapped and individualized ablation was made to eliminate inducible ATA.Results Left atrium to PV conduction relapses were evidenced in 14 patients.After re-ablation,there were no inducible ATA in 9 patients,inducible left atrial macro-reentry tachycardia in 3 patients and all were terminated by further linear ablation on the roof and left atrial isthmus,inducible atrial focal tachycardia from left atrial isthmus in 1 patient and was eliminated after additional focal ablation.inducible right atrial macro-reentry tachycardia in 2 patients and were eliminated by right isthmus linear ablation.During 1-16 (5.5±4.4) months follow-up,ATA was disappeared in 13 patients and reduced in another 2 patients.Conclusions Relapse of left atrium to PV conduction is one of the main mechanisms for postablation ATA in patients with A F.Atrial macro-reentry tachycardia and focal atrial tachycardia were less common mechanisms for postablation ATA.Re-ablation focused on closing the PV gaps and additional individualized focal and lineal ablation strategies were helpful for treating postablation ATA in AF patients.
