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Mechanisms of organized atrial tachycardia during catheter ablation of chronic atrial fibrillation by stepwise approach

NING Man DONG Jian-zeng LIU Xing-peng YU Rong-hui LONG De-yong TANG Ri-bo SANG Cai-hua MA Chang-sheng

中华医学杂志(英文版)2010,Vol.123Issue(7):852-856,5.
中华医学杂志(英文版)2010,Vol.123Issue(7):852-856,5.DOI:10.3760/cma.j.issn.0366-6999.2010.07.017

Mechanisms of organized atrial tachycardia during catheter ablation of chronic atrial fibrillation by stepwise approach

Mechanisms of organized atrial tachycardia during catheter ablation of chronic atrial fibrillation by stepwise approach

NING Man 1DONG Jian-zeng 1LIU Xing-peng 1YU Rong-hui 1LONG De-yong 1TANG Ri-bo 1SANG Cai-hua 1MA Chang-sheng1

作者信息

  • 1. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
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摘要

Abstract

Background Extensive atrial fibrillation (AF) ablation is associated with an increased success rate of catheter ablation in chronic AF patients and an increased rate of atrial tachycardia (AT) during the procedure. The mechanism of these Ats varies in previous studies. Our study aimed to report the mechanism of organized AT occurring during the stepwise ablation procedure of chronic AF.Methods A prospective cohort of 86 consecutive patients who underwent an ablation procedure for chronic atrial fibrillation (CAF) was investigated. The stepwise procedure was performed in the following order: circumferential pulmonary vein ablation, complex fractionated atrial electrograms ablation, mapping and ablation of AT. The endpoint was noninducibility of AF/AT after sinus rhythm (SR) was restored or the procedure time was beyond 6 hours.Results Sixty-nine (80%) of patients converted to SR via AT. A total of 179 sustained ATs were observed in 69 patients during the procedure. There were 81% (n=145) macroreentrant ATs which included 65 perimitral circuits, 48 peritricuspid tachycardia and 32 roof dependent circuits, 12% (n=21) localized reentrant and 7% (n=13) focal ATs. Thirty (15%) patients experienced significant left atrium (LA) and LA appendage (LAA) conduction delay or dissociation in the procedure or during the follow-up period.Conclusions Most CAF patients converted to SR via ablation of organized AT occurring during the stepwise procedure. The mechanism of most of these ATs was macro-reentry.

关键词

organized atrial tachycardia/chronic atrial fibrillation/catheter ablation/stepwise approach

Key words

organized atrial tachycardia/chronic atrial fibrillation/catheter ablation/stepwise approach

引用本文复制引用

NING Man,DONG Jian-zeng,LIU Xing-peng,YU Rong-hui,LONG De-yong,TANG Ri-bo,SANG Cai-hua ,MA Chang-sheng..Mechanisms of organized atrial tachycardia during catheter ablation of chronic atrial fibrillation by stepwise approach[J].中华医学杂志(英文版),2010,123(7):852-856,5.

基金项目

This work was supported by a grant from Beijing Science Foundation Council (No. 7072024). (No. 7072024)

中华医学杂志(英文版)

OACSCDCSTPCDMEDLINESCI

0366-6999

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