Radiofrequency Catheter Ablation of Atrial Tachycardia Under Navigation Using the EnSite Array

Abstract

Atrial tachycardia (AT) is sometimes difficult to eliminate by radiofrequency ablation (RFA), but the EnSite array (EA) visualizes the beat-to-beat virtual activation of any tachycardia. The 51 patients with 74 ATs (mean age 57+/-18 years, 28 males) undergoing EA-guided RFA were included; 14 patients had had previous open heart surgery and 5 had organic heart disease. RFA was performed at the AT focus for focal AT (n=48) with an endpoint of AT termination and subsequent non-inducibility. RFA was performed at a critical conducting pathway for reentrant AT (n=26) with creation of a block line in the critical reentry circuit. EA revealed that 57 ATs originated in the right atrium (77%) and 17 originated in the left atrium (23%); all but 1 were successfully eliminated. Fluoroscopic time was 19+/-11 min, the number of RFA applications was 8+/-7, and the radiofrequency energy was 10,711+/-12,655 J. No complications were noted. All but 2 patients were free of any symptoms during a follow-up of 16+/-9 months. EA-guided RFA is safe and effective for AT, irrespective of its mechanism, sustainability or origin, and regardless of underlying heart disease. (Circ J 2010; 74: 59 - 65).