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

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63 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

Keywords

  • Ablation
  • Atrial tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

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    Chen, C. C., Tai, C. T., Chiang, C. E., Yu, W. C., Lee, S. H., Chen, Y. J., Hsieh, M. H., Tsai, C. F., Lee, K. W., Ding, Y. A., Chang, M. S., & Chen, S. A. (2000). Atrial tachycardias originating from the atrial septum: Electrophysiologic characteristics and radiofrequency ablation. Journal of Cardiovascular Electrophysiology, 11(7), 744-749.