Focal ablation versus single vein isolation for atrial tachycardia originating from a pulmonary vein

Bryan Baranowski, Oussama Wazni, Bruce Lindsay, Mohammed Kanj, Walid Saliba, David Burkhardt, George Thomas, John Rickard, Patrick Tchou

Research output: Contribution to journalArticle

Abstract

Background: Rapid, disorganized firing from a pulmonary vein (PV) focus may initiate atrial fibrillation. The natural history of PV atrial tachycardia (AT), resulting in a slower, more organized form of firing, is less clear. Furthermore, the optimal therapeutic approach to a PV AT is poorly defined. Objective: This study assessed the characteristics and long-term outcomes of focal ablation versus PV isolation for ATs arising from a single PV. Methods: We reviewed 886 consecutive patients who underwent an AT radiofrequency ablation at our institution from January 1997 through August 2008. Results: Twenty-six patients had focal AT with a mean cycle length of 364 ± 90 ms that arose from within a single PV. Ten patients underwent focal ablation of their AT and 16 patients underwent PV isolation of the culprit vein. All procedures were acutely successful. The average follow-up was 25 months (range 2-90 months). There were three recurrences of AT in patients who underwent a focal ablation. There were no recurrences in patients who underwent targeted PV isolation (P = 0.046). No patients developed atrial fibrillation or AT from another focus during the follow-up period. Conclusion: PV AT can be successfully treated with single vein isolation or focal ablation with a low risk of recurrence or the development of atrial fibrillation. PV isolation may be the preferred approach when the AT focus arises from a site distal to the ostium where targeted ablation could result in phrenic nerve injury or occlusion of a pulmonary venous branch.

Original languageEnglish (US)
Pages (from-to)776-783
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume33
Issue number7
DOIs
StatePublished - Jul 1 2010

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Keywords

  • SVT
  • ablation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Baranowski, B., Wazni, O., Lindsay, B., Kanj, M., Saliba, W., Burkhardt, D., Thomas, G., Rickard, J., & Tchou, P. (2010). Focal ablation versus single vein isolation for atrial tachycardia originating from a pulmonary vein. PACE - Pacing and Clinical Electrophysiology, 33(7), 776-783. https://doi.org/10.1111/j.1540-8159.2010.02766.x