Sonia Busch1, Mathias Forkmann2, Karl-Heinz Kuck3, Thorsten Lewalter4, Hüseyin Ince5, Florian Straube6, Heinrich Wieneke7, K R Julian Chun8, Lars Eckardt9, Claus Schmitt10, Matthias Hochadel11, Jochen Senges11, Johannes Brachmann2. 1. Klinik für Kardiologie, Angiologie und Pneumologie, II. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Germany. sonia.busch@klinikum-coburg.de. 2. Klinik für Kardiologie, Angiologie und Pneumologie, II. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Germany. 3. Klinik für Kardiologie und internistische Intensivmedizin, Klinik für Kardiologie, Asklepios Klinik St. Georg, Hamburg, Germany. 4. Peter Osypka Herzzentrum München, Abteilung fuer Kardiologie und Innere Medizin, Graz, Germany. 5. Vivantes Klinikum Am Urban, Berlin, Klinik fuer Kardiologie und Internistische Intensivmedizin, Berlin, Germany. 6. Krankenhaus Muenchen Bogenhausen, Munich, Germany. 7. Klinik fuer Kardiologie und Angiologie, Contilia Herz- und Gefäßzentrum Essen, Essen, Germany. 8. CCB Cardioangiologisches Centrum Bethanien Frankfurt am Main, Frankfurt am Main, Germany. 9. Abteilung für Rhythmologie (Elektrophysiologie und kardiologische Elektrochirurgie), Universitätsklinikum Muenster, Muenster, Germany. 10. Staedtisches Klinikum Karlsruhe, Medizinische Klinik IV, Karlsruhe, Germany. 11. Stiftung Institut für Herzinfarktforschung Ludwigshafen, Ludwigshafen, Germany.
Abstract
INTRODUCTION: Catheter ablation of focal atrial tachycardia (FAT) can be a challenging procedure and results have been rarely described. The purpose of this study was to determine the characteristics and results of FAT ablation in the large cohort of the German Ablation Registry. METHODS: The German Ablation Registry is a nationwide prospective multicenter database including 12566 patients who underwent an ablation procedure between 2007 and 2010. Among them 431 (3.4%) underwent an FAT ablation and 413 patients with documented locations were analyzed. Patients were divided into three groups according to the FAT location: biatrial (BiA, n = 31, 7.5%), left atrial (LA, n = 110, 26.5%), and right atrial (RA, n = 272, 66%). RESULTS: Acute success rate was 84% (68 vs. 85 vs. 85% in biA, LA, and RA, respectively, p = 0.038). 4.8% of patients had an early recurrence during hospitalization, most in biatrial location (p < 0.001). No major acute complication occurred. At 12 months, 81% were asymptomatic or improved. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) was 3.7%. Arrhythmia freedom without antiarrhythmic drugs was 58% and was lower in biA (34 vs. 56% in LA vs. 62% in RA, p = 0.019). Early recurrence during hospitalization was an outstanding predictive factor for recurrence during follow-up. CONCLUSION: In this large patient population, FAT ablation had a relatively high acute success rate with a low complication rate. During follow-up, the recurrence rate was high, particularly in biatrial location. This was frequently predicted by an early recurrence during hospitalization.
INTRODUCTION: Catheter ablation of focal atrial tachycardia (FAT) can be a challenging procedure and results have been rarely described. The purpose of this study was to determine the characteristics and results of FAT ablation in the large cohort of the German Ablation Registry. METHODS: The German Ablation Registry is a nationwide prospective multicenter database including 12566 patients who underwent an ablation procedure between 2007 and 2010. Among them 431 (3.4%) underwent an FAT ablation and 413 patients with documented locations were analyzed. Patients were divided into three groups according to the FAT location: biatrial (BiA, n = 31, 7.5%), left atrial (LA, n = 110, 26.5%), and right atrial (RA, n = 272, 66%). RESULTS: Acute success rate was 84% (68 vs. 85 vs. 85% in biA, LA, and RA, respectively, p = 0.038). 4.8% of patients had an early recurrence during hospitalization, most in biatrial location (p < 0.001). No major acute complication occurred. At 12 months, 81% were asymptomatic or improved. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) was 3.7%. Arrhythmia freedom without antiarrhythmic drugs was 58% and was lower in biA (34 vs. 56% in LA vs. 62% in RA, p = 0.019). Early recurrence during hospitalization was an outstanding predictive factor for recurrence during follow-up. CONCLUSION: In this large patient population, FAT ablation had a relatively high acute success rate with a low complication rate. During follow-up, the recurrence rate was high, particularly in biatrial location. This was frequently predicted by an early recurrence during hospitalization.
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