TREATMENT OF REFRACTORY RECURRENT MULTIFOCAL ATRIAL TACHYCARDIA WITH ATRIOVENTRICULAR JUNCTION ABLATION AND PERMANENT PACING

Multifocal atrial tachycardia is a difficult clinical problem generall y associated with acute cardiorespiratory illness. The purpose of this study was to assess the feasibility and clinical utility of atriovent ricular junction ablation plus permanent transvenous pacemaker implant ation as therapy for uncontrolled refractory multifocal atrial tachyca rdia. Three patients with uncontrolled refractory multifocal atrial ta chycardia underwent atrioventricular junction ablation plus permanent transvenous pacemaker implantation. Complications and outcome of each procedure was monitored and both objective and subjective assessment o f physical functional capacity was assessed by a semiquantitative exam ination. Ablation procedures controlled the ventricular response in al l patients. There were no complications related to the ablation proced ure or implantation of permanent transvenous pacing system. All patien ts demonstrated subjective improvement in symptoms. Palpatations were virtually eradicated in these patients and all enjoyed significant imp rovements in rest and effort dyspnea, exercise tolerance and asthenia. Objective assessment of functional class also demonstrated significan t improvements. Atrioventricular ablation plus permanent transvenous p acing offers a safe and effective therapy for uncontrolled refractory multifocal atrial tachycardia.