Radiofrequency catheter ablation of atrial tachycardia

Abstract

Atrial tachycardia is a relatively uncommon arrhythmia which usually responds poorly to antiarrhythmic drug therapy. Transcatheter radiofrequency (RF) ablation is a new therapeutic modality for patients with atrial tachycardia. This study analyses our early experience with the treatment of atrial tachycardia by this technique. Thirteen consecutive patients (age 13-63 years) with 15 drug-refractory atrial tachycardia foci were treated with RF catheter ablation. Atrial tachycardia was mapped by seeking the earliest atrial activation in the right atrium in eight patients and in the left atrium in five. Tachycardias were abolished in nine (69%) patients, including two sinoatrial re-entrant tachycardias and seven automatic atrial tachycardias, after 9 +/- 10 (range, one to 28) pulses of RF current. Six of these ablated atrial tachycardia foci were right sided and three were on the left. One patient had three separate right atrial tachycardia foci; one was eliminated. Tachycardia recurred after two weeks in one patient with apparently successful ablation of sinoatrial re-entrant tachycardia. One patient with successful ablation of a right atrial tachycardia developed cardiac tamponade requiring surgical intervention. This study demonstrates that atrial tachycardia arising from diverse sites can be eliminated by RF catheter ablation.