Chinese Journal of Interventional Cardiology 2017;25(7):372-378

doi:10.3969/j.issn.1004-8812.2017.07.002

Mid and long-term outcomes of catheter ablation of recurrent atrial tachycardias post Mini-Maze surgery

Sulin ZHENG ; Xianzhang ZHAN ; Yumei XUE ; Xianhong FANG ; Hongtao LIAO ; Hai DENG ; Wei WEI ; Zili LIAO ; Fangzhou LIU ; Yang LIU ; Yuanhong LIANG ; Shulin WU

Keywords

Atrial fibrillation; Surgical ablation; Cox-Maze; Atrial tachycardia; Catheter ablation

Country

China

Language

Chinese

Abstract

Objective To analyze the clinical characteristics and follow-up data of catheter ablation of recurrent atrial tachycardias (ATs) after Mini-Maze surgery,and to explore prognostic factors for recurrence.Methods 59 patients in Guangdong General Hospital with ATs post Mini-Maze and concomitant open-heart surgery from April.2010 to June.2015 were included.According to high density precise mapping,activation mapping,voltage mapping and entrainment mapping,they underwent electrophysiological study and ablation which was guided by three-dimensional mapping system.All patients were followed up regularly.We explored the prognostic factors for recurrence by the Cox regression analysis.Results There were 88 types of ATs being mappedwith mean (1.49 ± 0.75) types of ATs identified per case.Most ATs were macro-reentry ATs(67/88,76.1％)and focal ATs (20/88,22.7％),respectively.56 patients (94.9％) achieved immediate ablation success.In a mean follow-up of (30.8 ± 17.7) months,recurrences were observed in 12 patients after the first time catheter ablation.Recurrent time was 3.5 (1.3,12.0) months and the overall ablation success rate was 74.6％ (44/59).6 patients received second ablation and the achievement of freedom from arrhythmias reached 79.7％ (47/59).Multivariate analysis showed that the LA diameter was the independent predictor for recurrence (HR 1.108,95％ CI 1.002 to 1.226,P =0.045).Conclusion Catheter ablation of ATs post Mini-Maze with concomitant surgery is save and feasible.LA diameter is the independent predictor for recurrence.