Outcome after tailored catheter ablation of atrial tachycardia using ultra-high-density mapping
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Outcome after tailored catheter ablation of atrial tachycardia using ultra-high-density mapping. / Jungen, Christiane; Akbulak, Ruken; Kahle, Ann-Kathrin; Eickholt, Christian; Schaeffer, Benjamin; Scherschel, Katharina; Dinshaw, Leon; Muenkler, Paula; Schleberger, Ruben; Nies, Moritz; Gunawardene, Melanie A; Klatt, Niklas; Hartmann, Jens; Merbold, Lydia; Jularic, Mario; Willems, Stephan; Meyer, Christian.
In: J CARDIOVASC ELECTR, Vol. 31, No. 10, 10.2020, p. 2645-2652.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Outcome after tailored catheter ablation of atrial tachycardia using ultra-high-density mapping
AU - Jungen, Christiane
AU - Akbulak, Ruken
AU - Kahle, Ann-Kathrin
AU - Eickholt, Christian
AU - Schaeffer, Benjamin
AU - Scherschel, Katharina
AU - Dinshaw, Leon
AU - Muenkler, Paula
AU - Schleberger, Ruben
AU - Nies, Moritz
AU - Gunawardene, Melanie A
AU - Klatt, Niklas
AU - Hartmann, Jens
AU - Merbold, Lydia
AU - Jularic, Mario
AU - Willems, Stephan
AU - Meyer, Christian
N1 - © 2020 The Authors. Journal of Cardiovascular Electrophysiology Published by Wiley Periodicals LLC.
PY - 2020/10
Y1 - 2020/10
N2 - INTRODUCTION: Tailored catheter ablation of atrial tachycardias (ATs) is increasingly recommended as a potentially easy treatment strategy in the era of high-density mapping (HDM). As follow-up data are sparse, we here report outcomes after HDM-guided ablation of ATs in patients with prior catheter ablation or cardiac surgery.METHODS AND RESULTS: In 250 consecutive patients (age 66.5 ± 0.7 years, 58% male) with ATs (98% prior catheter ablation, 13% prior cardiac surgery) an HDM-guided catheter ablation was performed with the support of a 64-electrode mini-basket catheter. A total of 354 ATs (1.4 ± 0.1 ATs per patient; mean cycle length 304 ± 4.3 ms; 64% macroreentry, 27% localized reentry, and 9% focal) with acute termination of 95% were targeted in the index procedure. A similar AT as in the index procedure recurred in five patients (2%) after a median follow-up time of 535 days (interquartile range (IQR) 25th-75th percentile: 217-841). Tailored ablation of reentry ATs with freedom from any arrhythmia was obtained in 53% after a single procedure and in 73% after 1.4 ± 0.4 ablation procedures (range: 1-4). A total of 228 patients (91%) were free from any arrhythmia recurrence after 210 days (IQR: 152-494) when including optimal usual care.CONCLUSIONS: Tailored catheter ablation of ATs guided by HDM has a high acute success rate. The recurrence rate of the index AT is low. In patients with extensive atrial scaring further ablation procedures need to be considered to achieve freedom from any arrhythmia.
AB - INTRODUCTION: Tailored catheter ablation of atrial tachycardias (ATs) is increasingly recommended as a potentially easy treatment strategy in the era of high-density mapping (HDM). As follow-up data are sparse, we here report outcomes after HDM-guided ablation of ATs in patients with prior catheter ablation or cardiac surgery.METHODS AND RESULTS: In 250 consecutive patients (age 66.5 ± 0.7 years, 58% male) with ATs (98% prior catheter ablation, 13% prior cardiac surgery) an HDM-guided catheter ablation was performed with the support of a 64-electrode mini-basket catheter. A total of 354 ATs (1.4 ± 0.1 ATs per patient; mean cycle length 304 ± 4.3 ms; 64% macroreentry, 27% localized reentry, and 9% focal) with acute termination of 95% were targeted in the index procedure. A similar AT as in the index procedure recurred in five patients (2%) after a median follow-up time of 535 days (interquartile range (IQR) 25th-75th percentile: 217-841). Tailored ablation of reentry ATs with freedom from any arrhythmia was obtained in 53% after a single procedure and in 73% after 1.4 ± 0.4 ablation procedures (range: 1-4). A total of 228 patients (91%) were free from any arrhythmia recurrence after 210 days (IQR: 152-494) when including optimal usual care.CONCLUSIONS: Tailored catheter ablation of ATs guided by HDM has a high acute success rate. The recurrence rate of the index AT is low. In patients with extensive atrial scaring further ablation procedures need to be considered to achieve freedom from any arrhythmia.
KW - Aged
KW - Atrial Fibrillation/surgery
KW - Catheter Ablation/adverse effects
KW - Electrophysiologic Techniques, Cardiac
KW - Female
KW - Humans
KW - Male
KW - Tachycardia, Supraventricular/diagnosis
KW - Treatment Outcome
U2 - 10.1111/jce.14703
DO - 10.1111/jce.14703
M3 - SCORING: Journal article
C2 - 32748442
VL - 31
SP - 2645
EP - 2652
JO - J CARDIOVASC ELECTR
JF - J CARDIOVASC ELECTR
SN - 1045-3873
IS - 10
ER -
