Supraventricular Tachycardia After Atrial Fibrillation Ablation

Atrial arrhythmias occur commonly after atrial fibrillation (AF) ablation. Initial conservative management with medical therapy and cardioversion is reasonable, particularly in the early period (first 3 months) after ablation, because many of these arrhythmias remit over time. However, definitive therapy with ablation may be required, depending on the clinical circumstances, and should focus on the putative mechanism of tachycardia and its likely location, both of which can be suggested by the initial AF ablation strategy. Response to pacing, entrainment, and electroanatomic activation mapping are useful to confirm the mechanism, define complex circuits, and guide ablation targets.