Catheter ablation of left atrial tachyarrhythmia: predictors of recurrence after catheter ablation

FUNDING ACKNOWLEDGEMENTS: Type of funding sources: None. BACKGROUND: Differently from catheter ablation (CA) of atrial fibrillation (AF), outcome data on CA of atrial re-entrant arrhythmias are scarce. PURPOSE: We sought to evaluate predictors of recurrence at follow up in this setting. METHODS: We analysed consecutive patients undergoing mapping and CA left atrial tachyarrhythmia. Three-dimensional high-density activation and voltage maps were created for each investigated tachycardia by means of CARTO® system. Left atrial (LA) size was measured as the anteroposterior diameter on parasternal long axis view on transthoracic echocardiogram. Severe LA enlargement was defined for LA diameter >47 mm in women and >52 mm in men in accordance with guidelines. RESULTS: Eighty-eight patients were considered (67 ± 9 years old, 45% males) undergoing 94 CA procedures (1.1 ± 0.3 per patient). Most patient had past medical history of pulmonary vein isolation (57%). In the investigated population, 120 tachycardia morphologies were mapped and ablated. Acute procedural success was achieved in 97% of cases without any major complication. After a mean follow-up of 17 ± 11 months, the overall freedom from atrial arrhythmia was 58% and 65% after single and repeat procedures, respectively. Severe LA enlargement was the only variable associated with arrhythmia recurrence at follow-up and it was consistent after single and repeat procedures (Figure 1 A-B). CONCLUSION: CA of complex left atrial tachyarrhythmia is safe and effective, and the mid- and long-term outcome is improved when LA is not severely enlarged. CA of should therefore be considered early in this patient population to achieve better clinical outcome. [Figure: see text]