Tuesday, July 15, 2008

Characterization of Left Atrial Tachyarrhythmias in Patients Following Atrial Fibrillation Ablation: Correlation of surface ECG with Intracardiac Mapping

Catheter based ablation has become a popular treatment strategy in the management of patients with atrial fibrillation (AF). Although patients undergoing AF ablation can expect success rates in excess of 80%, 1-3 the procedure is associated with a small risk of complications, the commonest of which is the development of organized atrial tachyarrhythmias i.e., atrial tachycardias (AT) and / or flutters.4 The latter includes both typical (isthmus dependent) and atypical (usually left atrial) flutter circuits. Common to all of these tachycardias is the presence of well defined, regularly occurring “P” waves which may help with localization as well as provide insights into arrhythmia mechanism(s). Ultimately this information has implications for successfully mapping and ablating the tachycardia. The purpose of this paper is to provide the readers with a concise overview on the various organized atrial tachyarrhythmias seen post AF ablation and discuss their ECG manifestations vis-à-vis information obtained from intracardiac mapping / ablation.

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