Atrial Tachycardia: Classification and Cathether

Ablation

Saverio Iacopino, MD, FACC, FESC

Tracy C. Cardiology Clinics. 1997;15:607-621.

Atrial Tachycardia ü  5-15% of all SVT’s

ü  Higher in pediatric population ü  Normal hearts ü  S/P surgery for congenital lesions

ü  Paroxysmal or persistent ü  Persistent atrial tachycardia can cause tachycardia

induced cardiomyopathy

ü  Variety of mechanisms ü  Reentry ü  Triggered and abnormal automaticity

Types of Atrial Tachycardias

ü  Focal origin ü  Triggered, automatic, reentrant

ü  Non-focal origin ü  Anatomically/functionally mediated ü  Scar mediated

ü  Location ü  Right or left atrium

Treatment of Atrial Tachycardia

RF Ablation

ü  No large reported series ü  Improved success with new catheter technology ü  Efficacy 80-98% ü  Recurrence 5-20% ü  Complications 1.6%

ü  Ablations for multiple foci less successful

Tracy C. Cardiology Clinics. 1997;15:607-621.

Atrial Tachycardia

Iterative Atrial Tachycardia

Target Site of Ablation

Early Activation

Atrial Tachycardia Block During RF