Acceleration of atrial ectopic tachycardia as a guide to successful radiofrequency ablation

Three children with atrial ectopic tachycardia (AET), ages 7-10 years, underwent radiofrequency ablation (RFA). Two had AET localized to the inferolateral orifice of the right atrial appendage, one had AET at the posteroinferior orifice of the left atrial appendage. Each patient received RFA at 15-16 watts for 30 seconds per application. Acceleration of AET rate was observed only during successful RFA application in each patient, occurring within 5 seconds and lasting 2-4 seconds. All unsuccessful applications failed to show this phenomenon. Observation of acceleration of AET rate during RFA was a useful predictor of successful procedure, possibly indicating destruction of abnormally automatic substrates.