Nonpharmacological treatment of atrial tachycardia

The authors analyse the efficacy and safety of catheter ablation and atrial pacing for the treatment of atrial tachycardia. Radiofrequency catheter ablation was selected whenever the arrhythmogenic focus was located on the free-wall or in the meso-septal area of the right atrium. In opposition, overdrive atrial pacing was chosen for tachycardias originating near the sinus complex or in the left atrium. Both therapies were safe, but had a low efficacy in converting the tachycardia into sinus rhythm. However, catheter ablation allows an irreversible destruction of small septally located foci. Thus, both the anatomical and the electrophysiological characteristics of the foci can be important factors in the selection of the most appropriate nonpharmacologic therapy.