FOCAL ATRIAL TACHYCARDIA - REANALYSIS OF THE CLINICAL AND ELECTROPHYSIOLOGIC CHARACTERISTICS AND PREDICTION OF SUCCESSFUL RADIOFREQUENCY ABLATION

Introduction: Reports about the clinical and electrophysiologic charac teristics of focal atrial tachycardia vary widely. Furthermore, the im pact of age, gender, associated cardiac diseases, mechanism, location of atrial tachycardia, and the prediction of results of radiofrequency catheter ablation was not clear. The purpose of this study was to fur ther understand the clinical and electrophysiologic characteristics of focal atrial tachycardia and the prediction of results of radiofreque ncy ablation. Methods and Results: We searched the literature publishe d between January 1969 and July 1997 using the key word ''atrial tachy cardia'' from the MEDLINE: and National Library of Medicine systems. T he items analyzed were age, sex, cardiac disease, mechanism, attack pa ttern, cycle length, location, number of atrial tachycardias, results of ablation, and recurrence after ablation. Multivariate analysis show ed that age and paroxysmal type of tachycardia were independent predic tors of nonautomatic mechanism; age and presence of other cardiac dise ases were independent predictors of multiple atrial tachycardias, and age also was the independent predictor of right-sided atrial tachycard ia. Atrial tachycardia located in the right atrium was the only signif icant predictor of successful radiofrequency catheter ablation. Other cardiac diseases and multiple atrial tachycardias were the significant predictors of recurrence after initial successful radiofrequency cath eter ablation. Conclusion: Patient age is closely related to the clini cal and electrophysiologic characteristics of atrial tachycardia based on our reanalysis, which found that patient age is an independent pre dictor of nonautomatic mechanism, right atrial location, existence of multiple atrial tachycardias, and recurrence of atrial tachycardia aft er initial successful ablation.