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. 2019 Mar 7;35(2):290-295.
doi: 10.1002/joa3.12172. eCollection 2019 Apr.

Long-term follow-up after radiofrequency ablation of ectopic atrial tachycardia in young patients

Cristina Balla  1 , Sara Foresti  2 , Hussam Ali  2 , Antonio Sorgente  3 , Gabriele Egidy Assenza  4 , Guido De Ambroggi  2 , Gianluca Epicoco  2 , Pierpaolo Lupo  2 , Riccardo Cappato  2   5
Affiliations

Long-term follow-up after radiofrequency ablation of ectopic atrial tachycardia in young patients

Cristina Balla et al. J Arrhythm. .

Abstract

Aim: Ectopic atrial tachycardia (EAT) is a common arrhythmia in children, adolescents, and young adults. Radiofrequency (RF) ablation is often considered the treatment of choice in this population. We sought to evaluate the long-term follow-up after RF ablation.

Methods and results: We retrospectively analyzed 36 young patients (age range 8-29 years), with clinical signs and symptoms suspected for EAT who underwent an electrophysiological study in our center. We evaluated the safety and acute success rate of ablation and the long-term follow-up. Ectopic foci were more frequently localized in the right atrium along the crista terminalis (28%) and EAT was successfully terminated in 97% of patients. At median follow-up (38 months), the recurrence rate was 20% with mostly recurrences expressed within 6 months.

Conclusions: The study confirmed the safety and high acute success rate of EAT ablation in a population of children, adolescents, and young adults. Therefore, catheter ablation of EAT can be considered early in the course of treatment of these patients. The evidence of most recurrences within 6 months could be useful for advising patients on likely outcomes.

Keywords: ablation; children; ectopic atrial tachycardia; young adults.

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Conflict of interest statement

Authors declare no conflict of interests for this article.

Figures

Figure 1
Figure 1
Anatomic location: a schematic representation of atrial ectopic foci distribution in the study population. (RAA right atrial appendage, IAS, interatrial septum, CT, crista terminalis, TA tricuspid annulus, CS coronary sinus, PVs pulmonary veins, LAA left atrial appendage, MA mitral annulus)
Figure 2
Figure 2
Focal atrial tachycardia termination during radiofrequency ablation at the superior portion of the tricuspid annulus. (A) and (B) left and right anterior oblique radiograms, respectively, showing the successful ablation site (white arrows). C, surface ECG and intracardiac recordings showing early bipolar activation (ABL d) and QS unipolar morphology (UNI 1) at the successful ablation site. D, Immediate tachycardia termination and restoration of sinus rhythm after RF onset. ABL: ablation catheter; CS: coronary sinus; d: distal; LAO and RAO: left and right anterior oblique projections, respectively; ORB: ventipolar orbiter catheter at the tricuspid annulus; p: proximal; RF: radiofrequency; UNI 1 and UNI 2: unipolar recordings from the distal poles of the ablation catheter
Figure 3
Figure 3
Rate of EAT recurrences at follow up: Kaplan‐Meier curve of EAT recurrence after ablation
Figure 4
Figure 4
Outcomes after ectopic atrial tachycardia (EAT) radiofrequency ablation (RFA)
See this image and copyright information in PMC

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