Vnitr Lek 2005, 51(10):1070-1078

Focal atrial tachycardia: Clinical manifestation, localization of ectopic foci, and results of catheter ablation

M. Fiala^1,2,*, J. Chovančík¹, P. Heinc², R. Neuwirth¹, R. Nevřalová¹, I. Nykl¹, M. Branny¹

¹ Kardiocentrum Nemocnice Podlesí, Třinec, přednosta prim MUDr. Marian Branny

² I. interní klinika Lékařské fakulty UP a FN, Olomouc, přednosta prof. MUDr. Jan Lukl, CSc.

Focal atrial tachycardia is an infrequent arrhythmia in adult patients.


The purpose of the study is presentation of clinical manifestation, localization of ectopic foci in the atria, and immediate and long-term results of catheter ablation.

Patients and methods:
Intracardiac mapping and catheter a ablation was employed in 50 patients (34 females), aged 44,9 ± 16,8 years, in 53 procedures.

Results:
A total of 50 ectopic foci, 36 in the right atrium or the inter-atrial septum, and 14 in the left atrium, were found and ablated. Noninducibility of the tachycardia at the end of the procedure was immediately achieved in all the patients. In 9 (18 %) patients, a different supraventricular monomorphic tachycardia was present and simultaneously eliminated. Three patients, in whom the target atrial tachycardia recurred, underwent a second ablation, which was successful. During long-term follow-up of 34.9 ± 27.4 months since the last ablation, the original tachycardia recurred in 3 (6 %) patients, nevertheless, clinical course significantly improved in two of these patients. Five patients experienced a different clinically significant atrial tachyarrhythmia (paroxysmal atrial fibrillation resp. inappropriate sinus tachycardia) that was successfully supressed with antiarrhythmic medication. Thus, in long term, original atrial tachycardia is completely eliminated in 47 (94 %) patients without need for antiarrhythmic drugs and 42 (84 %) patients did not have any arrhythmic problem.

Conclusion:
Focal atrial tachycardia manifests with different clinical and electrophysiological properties. Ectopic foci are localized in typical regions in both atria. Catheter ablation can be accomplished safely and with excellent long-term results.

Keywords: focal atrial tachycardia; ectopic foci; catheter ablation

Received: October 21, 2004; Accepted: February 3, 2005; Published: October 1, 2005  Show citation