Atrial Tachycardias Following Atrial Fibrillation Ablation

Publisher: Bentham Science Publishers

E-ISSN: 1875-6557 |11|2|149-156

ISSN: 1573-403x

Source: Current Cardiology Reviews, Vol.11, Iss.2, 2014-12, pp. : 149-156

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Abstract

One of the most important proarrhythmic complications after left atrial (LA) ablation is regular atrial tachycardia(AT) or flutter. Those tachycardias that occur after atrial fibrillation (AF) ablation can cause even more severe symptomsthan those from the original arrhythmia prior to the index ablation procedure since they are often incessant and associatedwith rapid ventricular response. Depending on the method and extent of LA ablation and on the electrophysiologicalproperties of underlying LA substrate, the reported incidence of late ATs is variable. To establish the exact mechanismof these tachycardias can be difficult and controversial but correlates with the ablation technique and in the vast majorityof cases the mechanism is reentry related to gaps in prior ablation lines. When tachycardias occur, conservative therapyusually is not effective, radiofrequency ablation procedure is mostly successful, but can be challenging, and requires acomplex approach.