Regular supraventricular tachycardias associated with idiopathic atrial fibrillation

Am J Cardiol. 2006 Nov 1;98(9):1242-4. doi: 10.1016/j.amjcard.2006.05.059. Epub 2006 Sep 12.

Abstract

The present study analyzed the recurrence rate of idiopathic atrial fibrillation (AF) after elimination by radiofrequency ablation of the substrate for a regular tachycardia. Forty consecutive patients with idiopathic AF and a history of regular palpitations or documented regular tachyarrhythmias were prospectively included. Regular tachyarrhythmias were induced in 82.5% of patients: atrial flutter (42.4% of the inducible arrhythmias), atrial tachycardia (24.2%), atrioventricular (AV) nodal reentry (18.2%), AV reentry through a concealed accessory pathway (9.1%), and AV nodal reentry associated with right atrial tachycardia (6.1%). Dual AV node physiology with single or dual AV node echoes was demonstrated in 6.1% of patients without inducible arrhythmias. During follow-up (92 +/- 11 months), AF recurred in 19.2% of patients after successful radiofrequency ablation and in 69.2% after unsuccessful or not performed procedures (p <0.05). Left atrial diameter did not change after successful ablation but increased significantly in the population without elimination of the substrate (initial diameter 37.5 +/- 2 mm, final diameter 46.4 +/- 3.2 mm; p <0.05). In conclusion, the systematic search for the substrate of regular tachyarrhythmias followed by their elimination by catheter ablation reduces the recurrence of idiopathic AF in patients with a history of regular palpitations or documented regular tachyarrhythmias.

MeSH terms

  • Adolescent
  • Adult
  • Analysis of Variance
  • Anti-Arrhythmia Agents / therapeutic use
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / physiopathology
  • Atrial Fibrillation / surgery
  • Atrial Flutter / etiology
  • Catheter Ablation
  • Electrophysiologic Techniques, Cardiac
  • Female
  • Follow-Up Studies
  • Heart Conduction System / physiopathology
  • Heart Conduction System / surgery
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Recurrence
  • Tachycardia, Supraventricular / complications*
  • Tachycardia, Supraventricular / drug therapy
  • Tachycardia, Supraventricular / physiopathology
  • Tachycardia, Supraventricular / surgery
  • Treatment Outcome

Substances

  • Anti-Arrhythmia Agents