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[Right atrial ablation of ectopic atrial tachycardia using a 20-pole mapping catheter].

AbstractINTRODUCTION:
Ectopic atrial tachycardia (EAT) are frequently unresponsive to pharmacological antiarrhythmic therapy. Radiofrequency ablation seems to be a safe approach to treat those arrhythmias. In the present study we report our results of radiofrequency ablation of EAT with a new mapping system (Stablemapr, Medtronic).
METHODS:
Thirty consecutive patients with right atrial tachycardia were included in the study. In 15 patients (G1) the 20-polar Stablemapr was used for localization of the arrhythmia foci. Data were compared with a control group (G2, n=15), in which mapping was performed conventionally. The demographic characteristics and the distribution of the different cardiac diseases were comparable in both groups. In group 1 the identification of the EAT was facilitated by the placement of the 20-pole mapping catheter in the right atrium. In group 2 point by point measurements were performed to find the earliest local atrial activation compared to a reference electrode in the high right atrium (activation mapping), or foci were identified by analysis of the P-wave morphology during stimulation (pacemapping).
RESULTS:
It was possible to successfully ablate all atrial tachycardias. The distribution of the foci was similar in both groups (G1/G2): near to the superior (3/5) and inferior (1/0) caval vene ostium, on the free wall (3/3), at the coronary sinus ostium (3/3) and on the interatrial septum (5/4). The mean procedure (G1: 88+/-33 vs G2: 151+/-61 min; p= or <0.05) and fluoroscopic times (G1: 19+/-9 vs G2: 38+/-28 min; p= or <0.05) were significantly shorter in group 1. Moreover, the mean number of radiofrequency applications was reduced significantly by using the new mapping system (G1: 10+/-10 vs G2: 16+/-13; p= or <0.05).
CONCLUSION:
Radiofrequency ablation of EAT with right atrial focus can be performed safely and successfully using a 20-pole mapping catheter. The greatest advantages compared to conventional mapping and ablation strategies lies in the shortened investigation and fluoroscopic time.
AuthorsP O Schueller, C Meyer, S Dierkes, C Perings, M G Hennersdorf
JournalHerzschrittmachertherapie & Elektrophysiologie (Herzschrittmacherther Elektrophysiol) Vol. 17 Issue 3 Pg. 121-6 (Sep 2006) ISSN: 0938-7412 [Print] Germany
Vernacular TitleAblation ektoper rechtsatrialer Tachykardien unter Verwendung eines 20-poligen Mapping-Katheters.
PMID16969725 (Publication Type: Controlled Clinical Trial, English Abstract, Journal Article)
Topics
  • Body Surface Potential Mapping (instrumentation, methods)
  • Cardiac Catheterization (instrumentation, methods)
  • Catheter Ablation (methods)
  • Heart Atria (surgery)
  • Humans
  • Middle Aged
  • Surgery, Computer-Assisted (methods)
  • Tachycardia, Ectopic Atrial (diagnosis, surgery)
  • Treatment Outcome

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