Atrial fibrillation is the most common persistent arrhythmia in the clinic. It affects a wide range of populations with high incidence, morbidity and mortality. Clinical studies have shown that ablation is one of the best means for the treatment of atrial fibrillation. However, after receiving ablation, some patients may experience atrial tachycardia and thus feel even deteriorated feelings. Understanding the predicting factors, electrophysiological mechanisms, and differential diagnosis and treatment strategies for post-ablation atrial tachycardia is essential for reducing the incidence and for the management of post-ablation atrial tachycardia. Therefore, we summarize the research progress of the above-mentioned aspects, and correspondingly proposes further research directions.
Atrial Fibrillation ; Catheter Ablation ; Humans ; Tachycardia, Supraventricular/surgery* ; Treatment Outcome

Polarity reversal mapping for localization of the left free wall accessory pathway (AP) at the atrial insertion site has been shown to be effective for successful ablation, but this technique requires atrial septal puncture. We evaluated the safety, efficacy, and reproducibility of two dimensional polarity reversal mapping at the ventricular insertion site of the accessory pathway without atrial septal puncture in symptomatic patients with manifested left free wall AP. Polarity reversal mapping under the mitral annulus by transaortic approach was performed in 10 consecutive patients with conventional ablation catheter (6 French, 4 mm tip, 2 mm interelectrode distance), during sinus rhythm or atrial pacing. A low set high, bandpass filter (0.005-400Hz) was used. Radiofrequency (RF) ablation was performed at the site of ventricular electrocardiogram polarity reversal during sinus rhythm. Polarity reversal was identified in all patients at the ventricular side of the mitral annulus. Ablation was successful in all patients without complications. The procedure time was 86.0 +/- 21.1 min, the fluoroscopic exposure time was 16 +/- 12 min, the number of RF applications was 8 +/- 6, the power level 21 +/- 7 watts, and the time to initial AP block was 3.0 +/- 0.9 sec. Polarity reversal mapping is a safe and efficient technique at the ventricular insertion site. This technique might be complementary to the currently-utilized activation mapping technique.
Adult ; Catheter Ablation/methods* ; Electrocardiography ; Electrodiagnosis* ; Female ; Heart Conduction System/physiopathology ; Human ; Male ; Middle Age ; Radiography, Thoracic ; Tachycardia, Supraventricular/surgery* ; Tachycardia, Supraventricular/physiopathology ; Tachycardia, Supraventricular/diagnosis*

In recent 10 years, using radiofrequency catheter ablation, our medical center has treated 4865 cases of paroxysmal supraventricular tachycardia (PSVT). To improve clinical practice, a retrospective analysis of this group was made. In this group, 2092 cases were atrioventricular reentry tachycardia (AVRT), including 1415 left accesory pathway and 677 right accesory pathway, and 2773 cases were atrioventricular nodal reentry tachycardia (AVNRT). The total success rate of radiofrequency treatment is 99.71%; the recurrence rate after half a year 1.73%; the total complication rate 1.25%. In conclusion, radiofrequency ablation is a safe and effective treatment for tachycardia with high rate of success and low rate of complication.
Adult ; Catheter Ablation ; Female ; Humans ; Male ; Retrospective Studies ; Tachycardia, Paroxysmal ; surgery ; Tachycardia, Supraventricular ; surgery ; Young Adult

Discrete radiofrequency lesion at the atrial insertion site of the tendon of Todaro in the perfused rabbit preparation lengthens A-H interval, mimicking fast pathway input ablation. This study attempts to define the cellular electrophysiology of the ablation region prior to and after the elimination of fast AV node conduction. In six superfused rabbit AV node preparations, the cellular electrophysiology around the region of the atrial insertion to the tendon of Todaro was recorded using standard microelectrode technique prior to and after ablation. Before ablation, the action potentials recorded in the area of proposed lesion were exclusively from atrial or AN cells. At postablation, the superior margin of the lesion was populated with atrial or AN cells. AN, N, or NH cells bordered the lower part of the lesion. Electrophysiology of surviving cells at the edges of the lesion showed no significant changes in their Vmax, APD50 or APD90 and MDP from preablation values. Fast AV node pathway input ablation in the rabbit heart can be accomplished with a singular lesion around the atrial insertion site of the tendon of Todaro, involving atrial or AN cells. The results of the studies imply that inputs to the compact node may act as a substrate for successful ablation of AV node reentry tachycardia.
Action Potentials/physiology ; Animal ; Atrioventricular Node/surgery* ; Atrioventricular Node/physiology ; Atrioventricular Node/cytology* ; Catheter Ablation/methods* ; Electrophysiology ; Rabbits ; Recovery of Function ; Tachycardia, Supraventricular/surgery ; Tachycardia, Supraventricular/physiopathology

Adult ; Catheter Ablation ; methods ; Humans ; Male ; Radial Artery ; surgery ; Tachycardia, Supraventricular ; surgery

Atrial Fibrillation ; surgery ; Catheter Ablation ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Tachycardia, Supraventricular ; diagnosis ; surgery

Atrial Appendage ; physiopathology ; Catheter Ablation ; Child ; Child, Preschool ; Female ; Humans ; Male ; Tachycardia, Ectopic Atrial ; etiology ; surgery ; Tachycardia, Supraventricular ; etiology ; surgery

Adolescent ; Catheter Ablation ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Tachycardia, Supraventricular ; surgery

Catheter Ablation ; methods ; Heart Atria ; surgery ; Heart Defects, Congenital ; surgery ; Humans ; Postoperative Complications ; prevention & control ; Tachycardia, Supraventricular ; prevention & control

Catheter Ablation ; Child ; Heart Septal Defects, Atrial ; surgery ; Humans ; Imaging, Three-Dimensional ; Male ; Tachycardia, Supraventricular ; surgery ; Tomography, X-Ray Computed