Europace Advance Access originally published online on April 10, 2008
Europace 2008 10(6):698-704; doi:10.1093/europace/eun091
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
ABLATION AND ABLATION TECHNIQUES
Ectopic atrial tachycardias with early activation at His site: radiofrequency ablation through a retrograde approach
1 Department of Cardiology, German Heart Institute Berlin, Augustenburgerplatz 1, Berlin 13353, Germany; 2 Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China; 3 Department of Cardiology, Klinikum Bayreuth, Preuschwitzerstrasse 101, Bayreuth 95445, Germany
Aims: The purpose of this study was to evaluate a retrograde approach for radiofrequency (RF) ablation of ectopic atrial tachycardias (EATs) with an early atrial activation at the His site.
Methods and results: This study included 12 patients with EAT. During tachycardia, earliest atrial activation was recorded at the His site at a standard catheter setting. Activation mapping was performed in the right atrium and along the mitral annulus and at the aortic root after retrograde insertion of the ablation catheter over the ascending aorta. In five patients, earliest atrial activation was recorded at the mitral annulus (in two patients at the superior-lateral annulus and in three patients at the inferior-medial annulus). In four of these patients, EAT could be successfully treated by RF ablation through the retrograde approach, whereas in one patient, a transseptal puncture was performed in order to achieve a stable catheter position. In seven patients, RF ablation at the non-coronary aortic sinus eliminated the tachycardia. During a follow-up period of 14 ± 8 months, there was no tachycardia recurrence.
Conclusion: In patients with EATs and early atrial activation at the His site, tachycardia may arise in the non-coronary aortic sinus or from the mitral annulus. Radiofrequency energy ablation can be performed through a retrograde approach in the majority of these patients and is safe and effective in eliminating this type of tachycardia.
Key Words: Ectopic atrial tachycardia, Non-coronary aortic sinus, Mitral annulus, Radiofrequency ablation
* Corresponding author. Tel: +49 30 4593 2436; fax: +49 30 4593 2438. E-mail address: kriatselis{at}gmx.de
Manuscript submitted 3 February 2008. Accepted after revision 19 March 2008.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  A. Rillig, U. Meyerfeldt, R. Birkemeyer, and W. Jung Ablation within the sinus of Valsalva for treatment of supraventricular and ventricular tachycardias: what is known so far? Europace, September 1, 2009; 11(9): 1142 - 1150. [Abstract] [Full Text] [PDF]
|
|