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Treatment of atrial automatic tachycardia by ablation procedures
Abstract:
Sixteen cases of atrial focus tachycardia are described clinically, electrophysiologically and hemodynamically. In each case multiple attempts at drug treatment (average 2.5 drugs) had failed. After delineation of the electrophysiologic mechanism, the patients were treated by surgical removal or cryoablation or catheter electroablation of the focus. In two of four patients catheter ablation was successful and without complication. Surgical treatment was successful in 13 of 14 patients. Left ventricular function, which had been abnormal in 10 patients, normalized in all but 1 patient whose echocardiographic shortening fraction improved from 10 to 27%. There have been no recurrences in a follow-up period of 6 months to 5 years (mean 2.2 years). It is recommended that any atrial automatic focus tachycardia that produces hemodynamic compromise undergo definitive treatment. Patients with chronic tachycardia rates of more than 140 beats/min should be followed up closely.
Insights
Drug-resistant atrial focus tachycardia can be effectively treated with ablation. Both surgical and catheter ablation methods showed high success rates, improving heart function and preventing recurrence in patients.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrial focus tachycardia is a challenging arrhythmia.
- Previous drug treatments had failed in these patients.
Purpose of the Study:
- To evaluate the efficacy of definitive treatments for atrial focus tachycardia.
- To assess the impact of these treatments on left ventricular function and recurrence rates.
Main Methods:
- Clinical, electrophysiologic, and hemodynamic evaluation.
- Surgical removal, cryoablation, or catheter ablation of the atrial focus.
- Follow-up for recurrence and cardiac function.
Main Results:
- Surgical treatment was successful in 13 of 14 patients; catheter ablation in 2 of 4.
- Abnormal left ventricular function normalized in most patients post-treatment.
- No recurrences were observed during a mean follow-up of 2.2 years.
Conclusions:
- Definitive treatment, including ablation, is recommended for hemodynamically compromising atrial automatic focus tachycardia.
- Close follow-up is advised for patients with chronic tachycardia exceeding 140 beats/min.