Outcomes after radiofrequency gatherer ablation of atrial tachycardia

The purpose of this study was to evaluate the efficacy, safety, and clinica l benefit of radiofrequency catheter ablation (RFCA) in a large series of p atients with atrial tachycardia (AT). The determinants of success or failur e of RFCA in AT remain unclear. We evaluated the results of radiofrequency ablation in 73 women and 32 men (mean age 48 +/- 19 years) with AT. Mapping techniques were based on identification of the earliest endocardial atrial electrogram recorded during AT. AT originated from the right atrium in 91 patients and from the left atrium in 14. The cardiac ventricles were dilate d in 12 patients, AT ablation was successful in 80 patients (77%) regardles s of the site of origin, Age, gender, rate of tachycardia, temperature achi eved during application, or presence of tachycardiomyopathy were not signif icant determinants of acute success by univariate analysis. There was a sig nificantly higher acute success rate of ablation in patients with paroxysma l (88%, 45 of 51) and permanent (71%, 30 of 42) forms than in patients with repetitive forms of AT (41%, 5 of 12) (p <0.005). The mean local endocardi al electrogram time (relative-to-surface P-wave onset) was -47 <plus/minus> 17 ms at successful ablation sites and -29 +/- 21 ms at unsuccessful sites (p <0.03). Ablation was unsuccessful in 25 cases. Thus, RFCA of AT con be performed with a high acute success rate. Patients with repetitive forms an d those with multifocal origin had a lower acute success rate. The highest incidence of recurrences was found in anterior right atrial foci. <(c)> 200 1 by Excerpta Medica, Inc.