Περίληψη:
Background/objectiveRadiofrequency catheter ablation (RFCA) of focal
atrial tachycardia (FAT) traditionally is guided by conventional
endocardial mapping of earliest atrial activation; however, more
recently electro-anatomical mapping is heralded as a more effective,
albeit more expensive, tool to guide ablation. Herein we present the
results of conventional mapping-guided RFCA. Apropos, we conducted a
literature search of studies reporting >10 FAT patients submitted to
RFCA.Methods and resultsConventional mapping-guided RFCA, performed in
63 FAT patients (aged 42.4+17.3years; 14 with incessant tachycardia and
12 with tachycardiomyopathy (TCM)), was successful in 61 (96.8%)
patients, applied for single foci in 59 (93.7%) and two foci in 4
patients, right (n=46) or left sided (n=17). The earliest atrial
activation time at the ablation site was 41.316.2ms. Fluoroscopy time
averaged 27.3+18.7min, and procedure lasted 2.6+1.7h. Complications
occurred in two patients (sinus pauses in one needing a pacemaker and a
large inguinal hematoma in one). Over 29.0+22.9months, four patients
(6.5%) had recurrences, of whom three were successfully re-ablated. All
patients with TCM showed gradual improvement to normalization over
4-6months. Literature search showed that RFCA success is equally high
when guided with either conventional (88.5%) or electro-anatomical
mapping (90%) with similar recurrences (9.6% vs.
9.5%).ConclusionConventional mapping-guided RFCA of FAT had high
success (96.8%) with low complication (3.2%) and recurrence rates
(6.5%). TCM was fully reversible. These results are comparable to those
achieved with the more expensive electro-anatomical mapping, which may
be reserved for more complex cases or for those failing the conventional
approach.
