Atrial tachycardias originating from the atrial septum: Electrophysiologic characteristics and radiofrequency ablation

Chien Cheng Chen, Ching Tai Tai, Chern En Chiang, Wen Chung Yu, Shih Huang Lee, Yi Jen Chen, Ming Hsiung Hsieh, Chin Feng Tsai, Kung Wei Lee, Yu An Ding, Mau Song Chang, Shih Ann Chen

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Introduction: The characteristics of atrial tachycardia (AT) have varied widely among different reports. The anatomic locations of ATs may bias the results. We propose that septal ATs and free-wall ATs have different characteristics. Methods and Results: One hundred forty-one patients with AT underwent electropharmacologic study, endocardial mapping, and radiofrequency ablation. Forty-nine (34.7%) patients had septal AT originating from the anteroseptal, mid-septal, and posteroseptal areas. Tachycardia cycle length was similar between septal AT and free-wall AT (367 ± 46 msec vs 366 ± 58 msec, P > 0.05). More patients with septal AT required isoproterenol to facilitate induction (44.9% vs 31.5%, P <0.05). Septal AT was more sensitive to adenosine than free-wall AT (84.4% vs 67.8%, P <0.05). Only posteroseptal AT showed a positive P wave in lead V1 and negative P wave in all the inferior leads (II, III, aVF). Radiofrequency catheter ablation had a comparable success rate for septal AT and free-wall AT (96% vs 95%) without impairment of AV conduction. During follow-up of 49 ± 13 months (range 17 to 85), the recurrence rate was similar for septal AT and free-wall AT (3.2% vs 4.6%, P = 0.08). Conclusion: Septal AT has electrophysiologic characteristics that are distinct from those of free-wall AT. Catheter ablation of the septal AT is safe and effective.

Original languageEnglish
Pages (from-to)744-749
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume11
Issue number7
Publication statusPublished - 2000
Externally publishedYes

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Atrial Septum
Tachycardia
Catheter Ablation
Septum of Brain

Keywords

  • Ablation
  • Atrial tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Atrial tachycardias originating from the atrial septum : Electrophysiologic characteristics and radiofrequency ablation. / Chen, Chien Cheng; Tai, Ching Tai; Chiang, Chern En; Yu, Wen Chung; Lee, Shih Huang; Chen, Yi Jen; Hsieh, Ming Hsiung; Tsai, Chin Feng; Lee, Kung Wei; Ding, Yu An; Chang, Mau Song; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 11, No. 7, 2000, p. 744-749.

Research output: Contribution to journalArticle

Chen, CC, Tai, CT, Chiang, CE, Yu, WC, Lee, SH, Chen, YJ, Hsieh, MH, Tsai, CF, Lee, KW, Ding, YA, Chang, MS & Chen, SA 2000, 'Atrial tachycardias originating from the atrial septum: Electrophysiologic characteristics and radiofrequency ablation', Journal of Cardiovascular Electrophysiology, vol. 11, no. 7, pp. 744-749.
Chen, Chien Cheng ; Tai, Ching Tai ; Chiang, Chern En ; Yu, Wen Chung ; Lee, Shih Huang ; Chen, Yi Jen ; Hsieh, Ming Hsiung ; Tsai, Chin Feng ; Lee, Kung Wei ; Ding, Yu An ; Chang, Mau Song ; Chen, Shih Ann. / Atrial tachycardias originating from the atrial septum : Electrophysiologic characteristics and radiofrequency ablation. In: Journal of Cardiovascular Electrophysiology. 2000 ; Vol. 11, No. 7. pp. 744-749.
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abstract = "Introduction: The characteristics of atrial tachycardia (AT) have varied widely among different reports. The anatomic locations of ATs may bias the results. We propose that septal ATs and free-wall ATs have different characteristics. Methods and Results: One hundred forty-one patients with AT underwent electropharmacologic study, endocardial mapping, and radiofrequency ablation. Forty-nine (34.7{\%}) patients had septal AT originating from the anteroseptal, mid-septal, and posteroseptal areas. Tachycardia cycle length was similar between septal AT and free-wall AT (367 ± 46 msec vs 366 ± 58 msec, P > 0.05). More patients with septal AT required isoproterenol to facilitate induction (44.9{\%} vs 31.5{\%}, P <0.05). Septal AT was more sensitive to adenosine than free-wall AT (84.4{\%} vs 67.8{\%}, P <0.05). Only posteroseptal AT showed a positive P wave in lead V1 and negative P wave in all the inferior leads (II, III, aVF). Radiofrequency catheter ablation had a comparable success rate for septal AT and free-wall AT (96{\%} vs 95{\%}) without impairment of AV conduction. During follow-up of 49 ± 13 months (range 17 to 85), the recurrence rate was similar for septal AT and free-wall AT (3.2{\%} vs 4.6{\%}, P = 0.08). Conclusion: Septal AT has electrophysiologic characteristics that are distinct from those of free-wall AT. Catheter ablation of the septal AT is safe and effective.",
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T1 - Atrial tachycardias originating from the atrial septum

T2 - Electrophysiologic characteristics and radiofrequency ablation

AU - Chen, Chien Cheng

AU - Tai, Ching Tai

AU - Chiang, Chern En

AU - Yu, Wen Chung

AU - Lee, Shih Huang

AU - Chen, Yi Jen

AU - Hsieh, Ming Hsiung

AU - Tsai, Chin Feng

AU - Lee, Kung Wei

AU - Ding, Yu An

AU - Chang, Mau Song

AU - Chen, Shih Ann

PY - 2000

Y1 - 2000

N2 - Introduction: The characteristics of atrial tachycardia (AT) have varied widely among different reports. The anatomic locations of ATs may bias the results. We propose that septal ATs and free-wall ATs have different characteristics. Methods and Results: One hundred forty-one patients with AT underwent electropharmacologic study, endocardial mapping, and radiofrequency ablation. Forty-nine (34.7%) patients had septal AT originating from the anteroseptal, mid-septal, and posteroseptal areas. Tachycardia cycle length was similar between septal AT and free-wall AT (367 ± 46 msec vs 366 ± 58 msec, P > 0.05). More patients with septal AT required isoproterenol to facilitate induction (44.9% vs 31.5%, P <0.05). Septal AT was more sensitive to adenosine than free-wall AT (84.4% vs 67.8%, P <0.05). Only posteroseptal AT showed a positive P wave in lead V1 and negative P wave in all the inferior leads (II, III, aVF). Radiofrequency catheter ablation had a comparable success rate for septal AT and free-wall AT (96% vs 95%) without impairment of AV conduction. During follow-up of 49 ± 13 months (range 17 to 85), the recurrence rate was similar for septal AT and free-wall AT (3.2% vs 4.6%, P = 0.08). Conclusion: Septal AT has electrophysiologic characteristics that are distinct from those of free-wall AT. Catheter ablation of the septal AT is safe and effective.

AB - Introduction: The characteristics of atrial tachycardia (AT) have varied widely among different reports. The anatomic locations of ATs may bias the results. We propose that septal ATs and free-wall ATs have different characteristics. Methods and Results: One hundred forty-one patients with AT underwent electropharmacologic study, endocardial mapping, and radiofrequency ablation. Forty-nine (34.7%) patients had septal AT originating from the anteroseptal, mid-septal, and posteroseptal areas. Tachycardia cycle length was similar between septal AT and free-wall AT (367 ± 46 msec vs 366 ± 58 msec, P > 0.05). More patients with septal AT required isoproterenol to facilitate induction (44.9% vs 31.5%, P <0.05). Septal AT was more sensitive to adenosine than free-wall AT (84.4% vs 67.8%, P <0.05). Only posteroseptal AT showed a positive P wave in lead V1 and negative P wave in all the inferior leads (II, III, aVF). Radiofrequency catheter ablation had a comparable success rate for septal AT and free-wall AT (96% vs 95%) without impairment of AV conduction. During follow-up of 49 ± 13 months (range 17 to 85), the recurrence rate was similar for septal AT and free-wall AT (3.2% vs 4.6%, P = 0.08). Conclusion: Septal AT has electrophysiologic characteristics that are distinct from those of free-wall AT. Catheter ablation of the septal AT is safe and effective.

KW - Ablation

KW - Atrial tachycardia

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