हृदय रोग एवं निदान

Characterization, Mapping and Catheter Ablation of Atrial Tachycardia with Prior Atriotomy

Abstract

Bin Luo, Xiaogang Guo, Qi Sun, Xu Liu, Jiandu Yang, Huiqiang Wei, Gongbu Zhou and Jian Ma

Introduction: The aim of this study was to develop bidirectional block of intra-atrial reentrant tachycardias (IARTs) late after the repair of congenital heart disease (CHD) using pace-map and entrainment mapping.
Methods and results: There were 106 patients enrolled in this study. These patients were divided into two groups as giant right atrium (RA) group and non-giant RA group based on their RA volume measured by Carto. All patients have performed activation and entrainment mapping among these patients, 24 (22.6%) of Giant RA group had dual-loop reentry and 82 patients had single loop reentry. 94 patients (88.7%) found out the gaps by pace-map in SR. Linear ablation was successful in 105 patients (99%). During a mean follow-up period of 105 ± 34 months the success rate of IARTs was 66%, there were significantly different in these two groups(P<0.01). Seven (6.6%) patients in Giant RA group undergone redo procedure.
Conclusion: Entrainment mapping in tachycardia and pace-map combined with three-dimensional electroanatomic mapping can elaborate the mechanism of complex re-entry circuits and critical isthmuses as targets for ablation. Pace-map in SR may be a good method for seeking the gap of ablation line to be bidirectional block for linear ablation IARTs.