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Treatment strategy and endpoint of catheter ablation for bi‐atrial tachycardia after substrate modification ablation in a low voltage zone of the left atrial anterior wall: Long‐term results

BACKGROUND: The termination of bi‐atrial tachycardia (BiAT) via the ablation of the Bachmann's bundle (BB) and mitral isthmus (MI) has been previously reported; however, the strategy and long‐term results of catheter ablation for BiAT remain unclear. METHODS: The data of nine patients with BiAT...

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Detalles Bibliográficos
Autores principales: Arai, Tomoyuki, Hojo, Rintaro, Tokioka, Sayuri, Kitamura, Takeshi, Fukamizu, Seiji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8339115/
https://www.ncbi.nlm.nih.gov/pubmed/34386126
http://dx.doi.org/10.1002/joa3.12558
Descripción
Sumario:BACKGROUND: The termination of bi‐atrial tachycardia (BiAT) via the ablation of the Bachmann's bundle (BB) and mitral isthmus (MI) has been previously reported; however, the strategy and long‐term results of catheter ablation for BiAT remain unclear. METHODS: The data of nine patients with BiAT who underwent low voltage zone (LVZ) ablation of the left atrial anterior wall (LAAW) after pulmonary vein isolation were reviewed. Patients with a P wave duration <100 ms during sinus rhythm underwent MI ablation and those with a P wave duration >100 ms underwent BB ablation. RESULTS: MI ablation was performed in three patients and six patients underwent BB ablation. The difference in the P wave duration before and after ablation was significantly different between the ablation sites (MI group: 5.0 ms difference; BB group; 38.5 ms difference; P = .024). The P wave duration was prolonged by >20 ms and was 120 ms or more after ablation in 5/6 patients who underwent BB ablation. The total recurrence rate was 11.0% (mean: 26.9 months). CONCLUSION: The recurrence of BiAT after MI or BB ablation is low. When BB ablation was performed, the P wave duration was prolonged by >20 ms and was at least 120 ms after the ablation, which may be an endpoint that can be used to measure the success of the ablation.