BACKGROUND: Although focal atrial tachycardias cannot be entrained, we hypothesized that atrial overdrive pacing (AOP) can be an effective adjunct to localize the focus of these tachycardias at the site where the post-pacing interval (PPI) is closest to the tachycardia cycle length (TCL). METHODS: Overdrive pacing was performed in nine patients during atrial tachycardia, and in a comparison group of 15 patients during sinus rhythm. Pacing at a rate slightly faster than atrial tachycardia in group 1 and sinus rhythm in group 2 was performed from five standardized sites in the right atrium and coronary sinus. The difference between the PPI and tachycardia or sinus cycle length (SCL) was recorded at each site. The tachycardia focus was then located and ablated in group 1, and the atrial site with earliest activation was mapped in group 2. RESULTS: In both groups the PPI-TCL at the five pacing sites reflected the distance from the AT focus or sinus node. In group 1, PPI-TCL at the successful ablation site was 11 +/- 8 msec. In group 2, PPI-SCL at the site of earliest atrial activation was 131 +/- 37 msec (P < 0.001 for comparison). In groups 1 and 2, calculated values at the five pacing sites were proportional to the distance from the AT focus or sinus node, respectively. CONCLUSIONS: The PPI-TCL after-AOP of focal atrial tachycardia has a direct relationship to proximity of the pacing site to the focus, and may be clinically useful in finding a successful ablation site.
BACKGROUND: Although focal atrial tachycardias cannot be entrained, we hypothesized that atrial overdrive pacing (AOP) can be an effective adjunct to localize the focus of these tachycardias at the site where the post-pacing interval (PPI) is closest to the tachycardia cycle length (TCL). METHODS: Overdrive pacing was performed in nine patients during atrial tachycardia, and in a comparison group of 15 patients during sinus rhythm. Pacing at a rate slightly faster than atrial tachycardia in group 1 and sinus rhythm in group 2 was performed from five standardized sites in the right atrium and coronary sinus. The difference between the PPI and tachycardia or sinus cycle length (SCL) was recorded at each site. The tachycardia focus was then located and ablated in group 1, and the atrial site with earliest activation was mapped in group 2. RESULTS: In both groups the PPI-TCL at the five pacing sites reflected the distance from the AT focus or sinus node. In group 1, PPI-TCL at the successful ablation site was 11 +/- 8 msec. In group 2, PPI-SCL at the site of earliest atrial activation was 131 +/- 37 msec (P < 0.001 for comparison). In groups 1 and 2, calculated values at the five pacing sites were proportional to the distance from the AT focus or sinus node, respectively. CONCLUSIONS: The PPI-TCL after-AOP of focal atrial tachycardia has a direct relationship to proximity of the pacing site to the focus, and may be clinically useful in finding a successful ablation site.
Authors: Jo Jo Hai; Anwar A Chahal; Paul A Friedman; Vaibhav R Vaidya; Faisal F Syed; Christopher V DeSimone; Sudip Nanda; Peter A Brady; Malini Madhavan; Yong-Mei Cha; Christopher J McLeod; Siva Mulpuru; Thomas M Munger; Douglas L Packer; Samuel J Asirvatham Journal: J Cardiovasc Electrophysiol Date: 2015-01-10
Authors: Ashok J Shah; Amir Jadidi; Xingpeng Liu; Shinsuke Miyazaki; Andrei Forclaz; Isabelle Nault; Lena Rivard; Nick Linton; Olivier Xhaet; Nicolas Derval; Frederic Sacher; Pierre Bordachar; Philippe Ritter; Meleze Hocini; Pierre Jais; Michel Haissaguerre Journal: Cardiol Res Pract Date: 2010-04-07 Impact factor: 1.866
Authors: Y Huo; A Arya; T Gaspar; S Richter; R Schoenbauer; P Sommer; A Bollmann; G Hindricks; C Piorkowski Journal: Herzschrittmacherther Elektrophysiol Date: 2012-06
Authors: Sergio Castrejón-Castrejón; Marta Ortega; Armando Pérez-Silva; David Doiny; Alejandro Estrada; David Filgueiras; José L López-Sendón; José L Merino Journal: Cardiol Res Pract Date: 2011-09-19 Impact factor: 1.866
Authors: Yae Min Park; Hyungdon Kook; Woohyeon Kim; Son Ki Lee; Jong-Il Choi; Hong Euy Lim; Sang Weon Park; Young-Hoon Kim Journal: Korean Circ J Date: 2013-01-31 Impact factor: 3.243