Coexisting sustained tachyarrthymia in patients with atrial fibrillation undergoing catheter ablation

Jin Kun Jang, Jae Seok Park, Yong Hyen Kim, Jong Il Choi, Hong Euy Lim, Hui Nam Pak, Young Hoon Kim

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background and Objectives: During the index procedure of catheter ablation (CA) for atrial fibrillation (AF), it is important to assess whether other atrial or ventricular tachyarrhythmia coexist. Their symptoms are often attributed to residual tachycardia after successful elimination of AF by CA. This tachycardia could also be non-pulmonary vein (PV) foci initiated AF. This study examined the coexistence of other sustained tachyarrhythmia of patients who underwent radiofrequency CA (RFCA) for AF. Subjects and Methods: Four hundred fifty-nine consecutive patients (375 males, aged 53.4±11.4 years) who underwent RFCA for AF were investigated. Atrial and ventricular programmed stimulation (PS) with or without isoproterenol infusion were performed, and spontaneously developed tachycardias were analyzed. Results: Fifteen patients (3.3% of total) were diagnosed to have other sustained arrhythmias that included slow-fast type atrioventricular nodal reentrant tachycardia (AVNRT, n=6), atrioventricular reentrant tachycardia (AVRT, n=5) that utilized left posteroseptal (n=4) and parahisian bypass tract (n=1), atrial tachycardia (AT, n=2) originating from the foramen ovale (n=1) and the ostium of coronary sinus (n=1), sustained ventricular tachycardia (VT, n=2) involving one from the apical posterolateral wall of left ventricule in a normal heart and one from an anterolateral wall in an underlying myocardial infarction (MI). These sustained tachycardias were neither clinically documented nor had structural heart diseases, with the exception of one patient with MI associated VT. Two patients had the triple tachycardia; one involved AVNRT, AVRT, and AF, and the other involved VT, AT, and AF. All associated tachycardias were successfully eliminated by RFCA. Conclusion: Fifteen (3.3%) patients with AF had coexisting sustained tachycardia. RFCA was successful in these patients. Identification of tachycardia by PS before RFCA for AF should be done to maximize the efficacy of the first ablation session.

Original languageEnglish
Pages (from-to)235-238
Number of pages4
JournalKorean Circulation Journal
Volume40
Issue number5
DOIs
Publication statusPublished - 2010 May 1

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Catheter Ablation
Tachycardia
Atrial Fibrillation
Myocardial Infarction
Foramen Ovale
Atrioventricular Nodal Reentry Tachycardia
Coronary Sinus
Ventricular Tachycardia
Isoproterenol
Cardiac Arrhythmias
Veins
Heart Diseases

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Jang, Jin Kun ; Park, Jae Seok ; Kim, Yong Hyen ; Choi, Jong Il ; Lim, Hong Euy ; Pak, Hui Nam ; Kim, Young Hoon. / Coexisting sustained tachyarrthymia in patients with atrial fibrillation undergoing catheter ablation. In: Korean Circulation Journal. 2010 ; Vol. 40, No. 5. pp. 235-238.
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abstract = "Background and Objectives: During the index procedure of catheter ablation (CA) for atrial fibrillation (AF), it is important to assess whether other atrial or ventricular tachyarrhythmia coexist. Their symptoms are often attributed to residual tachycardia after successful elimination of AF by CA. This tachycardia could also be non-pulmonary vein (PV) foci initiated AF. This study examined the coexistence of other sustained tachyarrhythmia of patients who underwent radiofrequency CA (RFCA) for AF. Subjects and Methods: Four hundred fifty-nine consecutive patients (375 males, aged 53.4±11.4 years) who underwent RFCA for AF were investigated. Atrial and ventricular programmed stimulation (PS) with or without isoproterenol infusion were performed, and spontaneously developed tachycardias were analyzed. Results: Fifteen patients (3.3{\%} of total) were diagnosed to have other sustained arrhythmias that included slow-fast type atrioventricular nodal reentrant tachycardia (AVNRT, n=6), atrioventricular reentrant tachycardia (AVRT, n=5) that utilized left posteroseptal (n=4) and parahisian bypass tract (n=1), atrial tachycardia (AT, n=2) originating from the foramen ovale (n=1) and the ostium of coronary sinus (n=1), sustained ventricular tachycardia (VT, n=2) involving one from the apical posterolateral wall of left ventricule in a normal heart and one from an anterolateral wall in an underlying myocardial infarction (MI). These sustained tachycardias were neither clinically documented nor had structural heart diseases, with the exception of one patient with MI associated VT. Two patients had the triple tachycardia; one involved AVNRT, AVRT, and AF, and the other involved VT, AT, and AF. All associated tachycardias were successfully eliminated by RFCA. Conclusion: Fifteen (3.3{\%}) patients with AF had coexisting sustained tachycardia. RFCA was successful in these patients. Identification of tachycardia by PS before RFCA for AF should be done to maximize the efficacy of the first ablation session.",
author = "Jang, {Jin Kun} and Park, {Jae Seok} and Kim, {Yong Hyen} and Choi, {Jong Il} and Lim, {Hong Euy} and Pak, {Hui Nam} and Kim, {Young Hoon}",
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Coexisting sustained tachyarrthymia in patients with atrial fibrillation undergoing catheter ablation. / Jang, Jin Kun; Park, Jae Seok; Kim, Yong Hyen; Choi, Jong Il; Lim, Hong Euy; Pak, Hui Nam; Kim, Young Hoon.

In: Korean Circulation Journal, Vol. 40, No. 5, 01.05.2010, p. 235-238.

Research output: Contribution to journalArticle

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T1 - Coexisting sustained tachyarrthymia in patients with atrial fibrillation undergoing catheter ablation

AU - Jang, Jin Kun

AU - Park, Jae Seok

AU - Kim, Yong Hyen

AU - Choi, Jong Il

AU - Lim, Hong Euy

AU - Pak, Hui Nam

AU - Kim, Young Hoon

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background and Objectives: During the index procedure of catheter ablation (CA) for atrial fibrillation (AF), it is important to assess whether other atrial or ventricular tachyarrhythmia coexist. Their symptoms are often attributed to residual tachycardia after successful elimination of AF by CA. This tachycardia could also be non-pulmonary vein (PV) foci initiated AF. This study examined the coexistence of other sustained tachyarrhythmia of patients who underwent radiofrequency CA (RFCA) for AF. Subjects and Methods: Four hundred fifty-nine consecutive patients (375 males, aged 53.4±11.4 years) who underwent RFCA for AF were investigated. Atrial and ventricular programmed stimulation (PS) with or without isoproterenol infusion were performed, and spontaneously developed tachycardias were analyzed. Results: Fifteen patients (3.3% of total) were diagnosed to have other sustained arrhythmias that included slow-fast type atrioventricular nodal reentrant tachycardia (AVNRT, n=6), atrioventricular reentrant tachycardia (AVRT, n=5) that utilized left posteroseptal (n=4) and parahisian bypass tract (n=1), atrial tachycardia (AT, n=2) originating from the foramen ovale (n=1) and the ostium of coronary sinus (n=1), sustained ventricular tachycardia (VT, n=2) involving one from the apical posterolateral wall of left ventricule in a normal heart and one from an anterolateral wall in an underlying myocardial infarction (MI). These sustained tachycardias were neither clinically documented nor had structural heart diseases, with the exception of one patient with MI associated VT. Two patients had the triple tachycardia; one involved AVNRT, AVRT, and AF, and the other involved VT, AT, and AF. All associated tachycardias were successfully eliminated by RFCA. Conclusion: Fifteen (3.3%) patients with AF had coexisting sustained tachycardia. RFCA was successful in these patients. Identification of tachycardia by PS before RFCA for AF should be done to maximize the efficacy of the first ablation session.

AB - Background and Objectives: During the index procedure of catheter ablation (CA) for atrial fibrillation (AF), it is important to assess whether other atrial or ventricular tachyarrhythmia coexist. Their symptoms are often attributed to residual tachycardia after successful elimination of AF by CA. This tachycardia could also be non-pulmonary vein (PV) foci initiated AF. This study examined the coexistence of other sustained tachyarrhythmia of patients who underwent radiofrequency CA (RFCA) for AF. Subjects and Methods: Four hundred fifty-nine consecutive patients (375 males, aged 53.4±11.4 years) who underwent RFCA for AF were investigated. Atrial and ventricular programmed stimulation (PS) with or without isoproterenol infusion were performed, and spontaneously developed tachycardias were analyzed. Results: Fifteen patients (3.3% of total) were diagnosed to have other sustained arrhythmias that included slow-fast type atrioventricular nodal reentrant tachycardia (AVNRT, n=6), atrioventricular reentrant tachycardia (AVRT, n=5) that utilized left posteroseptal (n=4) and parahisian bypass tract (n=1), atrial tachycardia (AT, n=2) originating from the foramen ovale (n=1) and the ostium of coronary sinus (n=1), sustained ventricular tachycardia (VT, n=2) involving one from the apical posterolateral wall of left ventricule in a normal heart and one from an anterolateral wall in an underlying myocardial infarction (MI). These sustained tachycardias were neither clinically documented nor had structural heart diseases, with the exception of one patient with MI associated VT. Two patients had the triple tachycardia; one involved AVNRT, AVRT, and AF, and the other involved VT, AT, and AF. All associated tachycardias were successfully eliminated by RFCA. Conclusion: Fifteen (3.3%) patients with AF had coexisting sustained tachycardia. RFCA was successful in these patients. Identification of tachycardia by PS before RFCA for AF should be done to maximize the efficacy of the first ablation session.

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