Mechanism of Recurrence of Atrial Tachycardia: Comparison Between First Versus Redo Procedures in a High-Resolution Mapping System.

Age Distribution Aged Analysis of Variance Atrial Fibrillation / diagnostic imaging Atrial Flutter / diagnostic imaging Body Surface Potential Mapping / methods Catheter Ablation / adverse effects Cohort Studies Databases, Factual Female Follow-Up Studies Humans Incidence Magnetocardiography / adverse effects Male Middle Aged Postoperative Complications / diagnostic imaging Recurrence Reoperation / methods Risk Assessment Severity of Illness Index Sex Distribution Time Factors
atrial fibrillation catheter ablation cicatrix ethanol humans

Journal

Circulation. Arrhythmia and electrophysiology
ISSN: 1941-3084
Titre abrégé: Circ Arrhythm Electrophysiol
Pays: United States
ID NLM: 101474365

Informations de publication

Date de publication:
01 2020
Historique:
pubmed: 16 1 2020
medline: 14 8 2020
entrez: 16 1 2020
Statut: ppublish

Résumé

Atrial fibrillation ablation-related atrial tachycardia (AT) is complex and may demonstrate several forms: anatomic macroreentrant AT (AMAT), non-AMAT, and focal AT. We aimed to elucidate the recurrence rate and mechanisms of atrial fibrillation ablation-related AT recurrence. Among 147 patients with ATs treated with the Rhythmia system, 68 (46.3%) had recurrence at mean 4.2 (2.9-11.6) months, and 44 patients received a redo procedure. AT circuits in the first procedure were compared with those in the redo procedure. Although mappable ATs were not observed in 7 patients, 68 ATs were observed in 37 patients during the first procedure: perimitral flutter (PMF) in 26 patients, roof-dependent macroreentrant AT (RMAT) in 18, peritricuspid flutter in 10, non-AMAT in 14, and focal AT in 3. During the redo AT ablation procedure, 54 ATs were observed in 41/44 patients: PMF in 24, RMAT in 14, peritricuspid flutter in 1, non-AMAT in 14, and focal AT in 1. Recurrence of PMF and RMAT was observed in 15 of 26 (57.7%) and 8 of 18 (44.4%) patients, respectively, while peritricuspid flutter did not recur. Neither the same focal AT nor the same non-AMAT were observed except in 1 case with septal scar-related biatrial AT. Epicardial structure-related ATs were involved in 18 of 24 (75.0%) patients in PMF, 4 of 14 (28.6%) in RMAT, and 4 of 14 (28.6%) in non-AMAT. Of 21 patients with a circuit including epicardial structures, 6 patients treated with ethanol infusion in the vein of Marshall did not show any AT recurrence, although 8 of 15 (53.3%) treated with radiofrequency showed AT recurrence ( Although high-resolution mapping may lead to correct diagnosis and appropriate ablation in the first procedure, the recurrence rate is still high. The main mechanism of atrial fibrillation ablation-related AT is the recurrence of PMF and RMAT or non-AMAT different from the first procedure. Epicardial structures (eg, coronary sinus/vein of Marshall system) are often involved, and ethanol infusion in the vein of Marshall may be an additional treatment.

Sections du résumé

BACKGROUND
Atrial fibrillation ablation-related atrial tachycardia (AT) is complex and may demonstrate several forms: anatomic macroreentrant AT (AMAT), non-AMAT, and focal AT. We aimed to elucidate the recurrence rate and mechanisms of atrial fibrillation ablation-related AT recurrence.
METHODS
Among 147 patients with ATs treated with the Rhythmia system, 68 (46.3%) had recurrence at mean 4.2 (2.9-11.6) months, and 44 patients received a redo procedure. AT circuits in the first procedure were compared with those in the redo procedure.
RESULTS
Although mappable ATs were not observed in 7 patients, 68 ATs were observed in 37 patients during the first procedure: perimitral flutter (PMF) in 26 patients, roof-dependent macroreentrant AT (RMAT) in 18, peritricuspid flutter in 10, non-AMAT in 14, and focal AT in 3. During the redo AT ablation procedure, 54 ATs were observed in 41/44 patients: PMF in 24, RMAT in 14, peritricuspid flutter in 1, non-AMAT in 14, and focal AT in 1. Recurrence of PMF and RMAT was observed in 15 of 26 (57.7%) and 8 of 18 (44.4%) patients, respectively, while peritricuspid flutter did not recur. Neither the same focal AT nor the same non-AMAT were observed except in 1 case with septal scar-related biatrial AT. Epicardial structure-related ATs were involved in 18 of 24 (75.0%) patients in PMF, 4 of 14 (28.6%) in RMAT, and 4 of 14 (28.6%) in non-AMAT. Of 21 patients with a circuit including epicardial structures, 6 patients treated with ethanol infusion in the vein of Marshall did not show any AT recurrence, although 8 of 15 (53.3%) treated with radiofrequency showed AT recurrence (
CONCLUSIONS
Although high-resolution mapping may lead to correct diagnosis and appropriate ablation in the first procedure, the recurrence rate is still high. The main mechanism of atrial fibrillation ablation-related AT is the recurrence of PMF and RMAT or non-AMAT different from the first procedure. Epicardial structures (eg, coronary sinus/vein of Marshall system) are often involved, and ethanol infusion in the vein of Marshall may be an additional treatment.

Identifiants

DOI: 10.1161/CIRCEP.119.007273 PMID: 31937120
pubmed: 31937120
doi: 10.1161/CIRCEP.119.007273
doi:

Types de publication

Comparative Study Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e007273

Commentaires et corrections

Type : CommentIn

Auteurs

Masateru Takigawa (M)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).
Heart Rhythm Center, Tokyo Medical and Dental University, Japan (M.T.).

Nicolas Derval (N)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Claire A Martin (CA)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).
Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (C.A.M.).

Konstantinos Vlachos (K)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Arnaud Denis (A)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Yosuke Nakatani (Y)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Takeshi Kitamura (T)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Ghassen Cheniti (G)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Felix Bourier (F)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Anna Lam (A)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Ruairidh Martin (R)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).
Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (R.M.).

Antonio Frontera (A)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Nathaniel Thompson (N)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Grégoire Massoullié (G)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Michael Wolf (M)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

William Escande (W)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Clémentine André (C)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Li-Jun Zeng (LJ)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Jean-Rodolphe Roux (JR)

Boston Scientific, Bordeaux, Aquitaine, France (J.-R.R.).

Josselin Duchateau (J)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Thomas Pambrun (T)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Frederic Sacher (F)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Hubert Cochet (H)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Mélèze Hocini (M)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Michel Haïssaguerre (M)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

Pierre Jaïs (P)

Cardiac Electrophysiology and Cardiac Stimulation Team, Bordeaux University Hospital (CHU), CHU Bordeaux, IHU Lyric, Université de Bordeaux, France (M.T., N.D., C.A.M., K.V., A.D., Y.N., T.K., G.C., F.B., A.L., R.M., A.F., N.T., G.M., M.W., W.E., C.A., L.-j.Z., J.D., T.P., F.S., H.C., M. Hocini, M. Haïssaguerre, P.J.).

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Classifications MeSH

questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › Répartition par âge › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de variance › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Fibrillation auriculaire › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Troubles du rythme cardiaque › Flutter auriculaire › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Électrocardiographie › Vectocardiographie › Cartographie du potentiel de surface corporelle › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Procédures de chirurgie opératoire › Techniques d'ablation › Ablation par radiofréquence › Ablation par cathéter › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Sciences de l'information › Mémorisation et recherche des informations › Bases de données comme sujet › Bases de données factuelles › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Registre civil › Morbidité › Incidence › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Techniques d'investigation › Magnétométrie › Magnétocardiographie › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Complications postopératoires › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Récidive › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Procédures de chirurgie opératoire › Réintervention › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Appréciation des risques › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enquêtes et questionnaires › Enquêtes de santé › Indicateurs d'état de santé › Acuité des besoins du patient › Indice de gravité de la maladie › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Mesures épidémiologiques › Démographie › Répartition par sexe › Mechanism of Recurrence of Atrial Tachycardia:...
questionsmedicales.fr › Phénomènes physiques › Temps › Facteurs temps › Mechanism of Recurrence of Atrial Tachycardia:...