Clinical significance of induced atrial tachycardia after termination of longstanding persistent atrial fibrillation using a stepwise approach

Yasutsugu Nagamoto, Jae Seok Park, Daniel Tanubudi, Yiu Kwan Ko, Ji Eun Ban, Jae Jin Kwak, Jongil Choi, Hong Euy Lim, Sang Weon Park, Young Hoon Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Induced Atrial Tachyarrhythmia During Atrial Fibrillation Ablation. Introduction: The utility of inducibility test of atrial tachycardia (AT) in patients with longstanding persistent atrial fibrillation (AF; LPAF) is unclear. This study aimed to evaluate the significance of induced AT and the impact of their ablation on the clinical outcome. Methods: In 194 patients with LPAF (>1 year) who underwent catheter ablation (pulmonary vein isolation with substrate ablation), an inducibility test was performed after AF termination. Results: AT was induced in 108 (56%) patients (induced AT group); neither AT nor AF was inducible in 37 (19%, noninduction group). During 39 ± 21 months, AT recurred in 30 patients (28%), AF in 19 (17%), and no arrhythmia in 56 (52%) among induced AT group, although there was a recurrence of AT in 9 (24%, P = 0.68), AF in 6 (16%, P = 0.85), and no arrhythmia in 22 (60%, P = 0.42) among noninduction group (P = NS). Note that 10 patients with repeated ablation in induced AT group revealed 8 different and 2 similar recurrent ATs compared to the induced ATs at first session. The mean cycle length of induced AT that terminated by ablation (271 ± 64 ms) was longer than that without (249 ± 58 ms, P < 0.05). In induced AT group, AT recurrence rate in patients who achieved AT termination by ablation was lower than those without termination (5% vs 36%, P < 0.05). Conclusions: ATs that are inducible after LPAF termination do not necessarily become clinical AT. However, patients who achieved noninducibility of AT by ablating slower cycle length of AT had better outcomes. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1171-1178, November 2012)

Original languageEnglish
Pages (from-to)1171-1178
Number of pages8
JournalJournal of Cardiovascular Electrophysiology
Volume23
Issue number11
DOIs
Publication statusPublished - 2012 Nov 1

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Tachycardia
Atrial Fibrillation
Cardiac Arrhythmias
Recurrence
Catheter Ablation
Pulmonary Veins

Keywords

  • atrial fibrillation
  • atrial tachycardia
  • catheter ablation
  • inducibility test

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Clinical significance of induced atrial tachycardia after termination of longstanding persistent atrial fibrillation using a stepwise approach. / Nagamoto, Yasutsugu; Park, Jae Seok; Tanubudi, Daniel; Ko, Yiu Kwan; Ban, Ji Eun; Kwak, Jae Jin; Choi, Jongil; Lim, Hong Euy; Park, Sang Weon; Kim, Young Hoon.

In: Journal of Cardiovascular Electrophysiology, Vol. 23, No. 11, 01.11.2012, p. 1171-1178.

Research output: Contribution to journalArticle

Nagamoto, Yasutsugu ; Park, Jae Seok ; Tanubudi, Daniel ; Ko, Yiu Kwan ; Ban, Ji Eun ; Kwak, Jae Jin ; Choi, Jongil ; Lim, Hong Euy ; Park, Sang Weon ; Kim, Young Hoon. / Clinical significance of induced atrial tachycardia after termination of longstanding persistent atrial fibrillation using a stepwise approach. In: Journal of Cardiovascular Electrophysiology. 2012 ; Vol. 23, No. 11. pp. 1171-1178.
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abstract = "Induced Atrial Tachyarrhythmia During Atrial Fibrillation Ablation. Introduction: The utility of inducibility test of atrial tachycardia (AT) in patients with longstanding persistent atrial fibrillation (AF; LPAF) is unclear. This study aimed to evaluate the significance of induced AT and the impact of their ablation on the clinical outcome. Methods: In 194 patients with LPAF (>1 year) who underwent catheter ablation (pulmonary vein isolation with substrate ablation), an inducibility test was performed after AF termination. Results: AT was induced in 108 (56{\%}) patients (induced AT group); neither AT nor AF was inducible in 37 (19{\%}, noninduction group). During 39 ± 21 months, AT recurred in 30 patients (28{\%}), AF in 19 (17{\%}), and no arrhythmia in 56 (52{\%}) among induced AT group, although there was a recurrence of AT in 9 (24{\%}, P = 0.68), AF in 6 (16{\%}, P = 0.85), and no arrhythmia in 22 (60{\%}, P = 0.42) among noninduction group (P = NS). Note that 10 patients with repeated ablation in induced AT group revealed 8 different and 2 similar recurrent ATs compared to the induced ATs at first session. The mean cycle length of induced AT that terminated by ablation (271 ± 64 ms) was longer than that without (249 ± 58 ms, P < 0.05). In induced AT group, AT recurrence rate in patients who achieved AT termination by ablation was lower than those without termination (5{\%} vs 36{\%}, P < 0.05). Conclusions: ATs that are inducible after LPAF termination do not necessarily become clinical AT. However, patients who achieved noninducibility of AT by ablating slower cycle length of AT had better outcomes. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1171-1178, November 2012)",
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AU - Nagamoto, Yasutsugu

AU - Park, Jae Seok

AU - Tanubudi, Daniel

AU - Ko, Yiu Kwan

AU - Ban, Ji Eun

AU - Kwak, Jae Jin

AU - Choi, Jongil

AU - Lim, Hong Euy

AU - Park, Sang Weon

AU - Kim, Young Hoon

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N2 - Induced Atrial Tachyarrhythmia During Atrial Fibrillation Ablation. Introduction: The utility of inducibility test of atrial tachycardia (AT) in patients with longstanding persistent atrial fibrillation (AF; LPAF) is unclear. This study aimed to evaluate the significance of induced AT and the impact of their ablation on the clinical outcome. Methods: In 194 patients with LPAF (>1 year) who underwent catheter ablation (pulmonary vein isolation with substrate ablation), an inducibility test was performed after AF termination. Results: AT was induced in 108 (56%) patients (induced AT group); neither AT nor AF was inducible in 37 (19%, noninduction group). During 39 ± 21 months, AT recurred in 30 patients (28%), AF in 19 (17%), and no arrhythmia in 56 (52%) among induced AT group, although there was a recurrence of AT in 9 (24%, P = 0.68), AF in 6 (16%, P = 0.85), and no arrhythmia in 22 (60%, P = 0.42) among noninduction group (P = NS). Note that 10 patients with repeated ablation in induced AT group revealed 8 different and 2 similar recurrent ATs compared to the induced ATs at first session. The mean cycle length of induced AT that terminated by ablation (271 ± 64 ms) was longer than that without (249 ± 58 ms, P < 0.05). In induced AT group, AT recurrence rate in patients who achieved AT termination by ablation was lower than those without termination (5% vs 36%, P < 0.05). Conclusions: ATs that are inducible after LPAF termination do not necessarily become clinical AT. However, patients who achieved noninducibility of AT by ablating slower cycle length of AT had better outcomes. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1171-1178, November 2012)

AB - Induced Atrial Tachyarrhythmia During Atrial Fibrillation Ablation. Introduction: The utility of inducibility test of atrial tachycardia (AT) in patients with longstanding persistent atrial fibrillation (AF; LPAF) is unclear. This study aimed to evaluate the significance of induced AT and the impact of their ablation on the clinical outcome. Methods: In 194 patients with LPAF (>1 year) who underwent catheter ablation (pulmonary vein isolation with substrate ablation), an inducibility test was performed after AF termination. Results: AT was induced in 108 (56%) patients (induced AT group); neither AT nor AF was inducible in 37 (19%, noninduction group). During 39 ± 21 months, AT recurred in 30 patients (28%), AF in 19 (17%), and no arrhythmia in 56 (52%) among induced AT group, although there was a recurrence of AT in 9 (24%, P = 0.68), AF in 6 (16%, P = 0.85), and no arrhythmia in 22 (60%, P = 0.42) among noninduction group (P = NS). Note that 10 patients with repeated ablation in induced AT group revealed 8 different and 2 similar recurrent ATs compared to the induced ATs at first session. The mean cycle length of induced AT that terminated by ablation (271 ± 64 ms) was longer than that without (249 ± 58 ms, P < 0.05). In induced AT group, AT recurrence rate in patients who achieved AT termination by ablation was lower than those without termination (5% vs 36%, P < 0.05). Conclusions: ATs that are inducible after LPAF termination do not necessarily become clinical AT. However, patients who achieved noninducibility of AT by ablating slower cycle length of AT had better outcomes. (J Cardiovasc Electrophysiol, Vol. 23, pp. 1171-1178, November 2012)

KW - atrial fibrillation

KW - atrial tachycardia

KW - catheter ablation

KW - inducibility test

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