Ablation of Focal atrial Tachycardia—Demographics, Characteristics and Outcomes

Abstract

Introduction: Focal atrial tachycardia (AT) is a common arrhythmia that can be treated with catheter ablation. It has been reported to have preferential sites with previous studies suggesting a slight predominance to the right atrium. However data are only available from a limited number of institutions and it is unclear whether these are applicable to other populations. We present the electrophysiologic characteristics and outcomes of focal AT treated with catheter ablation at our institution. Methods: Retrospective analysis of demographic and electrophysiological characteristics of patientswhounderwent focal AT ablation over a five year period. Results: Sixty-three patients underwent catheter ablation for AT with a mean follow up of 28 months (range 5–66). Seventy-six percent females, mean age 59 (22–85). Eleven had more than one arrhythmia induced – AVNRT (n= 6), atrial flutter (n= 4) and RVOT-VT (n= 1). nine patients had more than one focus with 72 sites in 63 patients ablated. 59/72 were right sided (82%). Most common sites were crista terminalis (n= 35), tricuspid annulus (n= 8), CS os (n= 8), RAA (n= 5), AMC (n= 4), pulmonary veins (n= 4), perinodal (n= 3), left septum (n= 3), CS body (n= 1), LAA (n= 1). A total of 73 procedures were performed in 63 patients, with 84% success after first procedure rising to 97% with a mean of 1.13 procedures/patient. Conclusion: In contrast topreviously reported series,we report a marked preponderance of right-sided foci, with crista terminalis accounting for almost half. Multiple foci and other arrhythmias appear common. Catheter ablation is associatedwith high success rate atmedium term follow up.