Electrophysiological and clinical characteristics of catheter ablation for isolated left side atrial tachycardia over a 10-year period

Jennifer J.B. Vicera, Yenn Jiang Lin, Chin Yu Lin, Dai Yin Lu, Shih Lin Chang, Li Wei Lo, Fa Po Chung, Tze Fan Chao, Yu Feng Hu, Ta Chuan Tuan, Jo Nan Liao, Yun Yu Chen, Rubiana Sukardi, Simon Salim, Cheng I. Wu, Chih Min Liu, Quang Minh Hoang, Vu Van Ba, Ting Chun Huang, Chieh Mao ChuangChun Chao Chen, Chye Gen Chin, Ling Kuo, Shih Ann Chen

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aims: Most left atrial tachycardia (LAT) is associated with atrial fibrillation (AF). The clinical and electrophysiological characteristics and outcomes of LAT without AF have not been investigated. This study sought to determine the long-term ablation outcomes and predictors of recurrence of isolated LAT. Methods: This is a single-center study of consecutive patients with isolated LAT. Atrial arrhythmia recurrence was determined from follow-up records of patients who underwent LAT ablation from 2008 to 2017. Clinical and electrophysiologic characteristics associated with atrial arrhythmia recurrence were identified. Results: A total of 50 patients (53 ± 19 years, 46% male) with 59 LAT (1.16 ± 0.47 per patient) were enrolled. Over a mean follow-up of 37 ± 33 months, atrial arrhythmia recurrence occurred in 22 (44%) patients, 11 with atrial tachycardia (AT) only, five with AF only, and six with concurrent AT and AF. The incidence of pulmonary vein (PV) origins increased significantly in the repeat procedure (P = 0.036). Multivariate analysis identified left ventricular ejection fraction (LVEF) as the only predictor of any atrial arrhythmia recurrence and LAT recurrence, while smoking and identified macroreentrant LAT in the index procedure predicted AF recurrence. Conclusion: This study demonstrated a higher rate of atrial arrhythmia recurrence, including AF, among patients with initially isolated LAT. A lower LVEF predicted any atrial arrhythmia and LAT recurrence, whereas smoking and index macroreentrant AT mechanism predicted long-term AF. PV ATs were frequently observed in recurrent patients irrespective of index procedure origin.

Original languageEnglish
Pages (from-to)1013-1025
Number of pages13
JournalJournal of Cardiovascular Electrophysiology
Volume30
Issue number7
DOIs
Publication statusPublished - Jul 2019
Externally publishedYes

Keywords

  • ablation
  • atrial fibrillation
  • follow-up
  • left atrial tachycardia
  • recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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  • Cite this

    Vicera, J. J. B., Lin, Y. J., Lin, C. Y., Lu, D. Y., Chang, S. L., Lo, L. W., Chung, F. P., Chao, T. F., Hu, Y. F., Tuan, T. C., Liao, J. N., Chen, Y. Y., Sukardi, R., Salim, S., Wu, C. I., Liu, C. M., Hoang, Q. M., Ba, V. V., Huang, T. C., ... Chen, S. A. (2019). Electrophysiological and clinical characteristics of catheter ablation for isolated left side atrial tachycardia over a 10-year period. Journal of Cardiovascular Electrophysiology, 30(7), 1013-1025. https://doi.org/10.1111/jce.13945