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[Radiofrequency catheter ablation of atrial tachycardia].

BACKGROUND AND OBJECTIVE
Radiofrequency catheter ablation has proved to be highly effective for the treatment of supraventricular tachycardia originating in the AV node or related to atrioventricular accessory pathways. However, experience with ablation of atrial tachycardia is more limited. The purpose of our study was to analyse the success and safety of radiofrequency ablation of atrial tachycardias.


STUDY POPULATION
Ten symptomatic patients with drug refractory atrial tachycardia. Symptoms included palpitations, dizziness, chest pains, shortness of breath, syncope. Five patients had reduced left ventricular ejection fraction (tachycardiomyopathy).


METHODS
Radiofrequency device - Medtronic ATAKRR with temperature monitoring. Temperature ranges from 50 degrees C to 70 degrees C were considered optimal to ablation. Ablation catheter - 7 F CardiorhythmR with a 4 mm2 deflectable tip. Heparin was given intravenously during the procedure (5000 IU bolus + 1000 IU/h). Acetylsalicylic acid 160 mg/day for 1 month after the procedure. Antiarrhythmic drugs were discontinued after the procedure. The sites for ablation were defined during tachycardia by the earliest endocardial atrial activation as compared to the onset of the surface P wave. Criteria of success: Abolition of the tachycardia followed by the inability to reinduce the tachycardia.


FOLLOW-UP
Clinical, ECG and 2D ECHO evaluation in the outpatient's clinic. No complications occurred during the procedure. No reccurrences of the tachycardia were observed during the follow-up. All 5 patients with reduced ejection fraction before ablation had normal left ventricular function during follow-up.


CONCLUSION
Radiofrequency catheter ablation is a safe and effective treatment for drug refractory atrial tachycardia.