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Atrial tachycardia during ongoing atrial fibrillation ablation. - EnSite array analysis-
Yasutsugu Nagamoto1, Takeshi Tsuchiya, Koji Miyamoto
1First Department of Internal Medicine, Faculty of Medicine, Oita University, Oita, Japan.
Summary
Atrial tachycardia (AT) during atrial fibrillation (AF) ablation is common. EnSite Array (EA) helps identify and eliminate these ATs, improving patient outcomes and reducing recurrence.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Devices
Background:
- Atrial tachycardia (AT) can complicate atrial fibrillation (AF) ablation.
- Accurate identification and elimination of AT during AF ablation remain challenging.
- EnSite Array (EA) offers beat-to-beat virtual activation mapping for AT visualization.
Purpose of the Study:
- To characterize AT occurring during AF ablation using EA.
- To assess the efficacy of EA-guided ablation for AT during AF ablation.
Main Methods:
- Ninety patients undergoing AF ablation during ongoing AF were studied.
- EnSite Array (EA) was used to visualize and guide ablation of AT.
- Radiofrequency catheter ablation was performed for identified ATs.
Main Results:
- 37% of patients developed AT during AF ablation; 10% developed AT before ablation.
- ATs were focal (19) or macroreentrant (27), with common locations including pulmonary veins and peri-mitral regions.
- EA-guided ablation rendered 85% of ATs non-inducible, with 91% freedom from AF/AT recurrence at follow-up.
Conclusions:
- AT frequently occurs during AF ablation and originates from diverse focal or reentrant mechanisms.
- Peri-mitral AT, common atrial flutter, and pulmonary vein AT are common.
- EA-guided radiofrequency ablation effectively eliminates these ATs, leading to high success rates.
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