Multiple focal atrial tachycardias in a healthy adult population: Characterization and description of successful radiofrequency ablation

BackgroundThe electrophysiologic (EP) characteristics and ablation outcomes of focal atrial tachycardia (AT) have been extensively characterized over recent years. However, there are limited published data describing patients who at EP study have more than one sustained focal tachycardia.ObjectiveTo characterize the demographics, tachycardia data, and outcome of patients with successful ablation of more than one focal AT.MethodsA retrospective review of our supraventricular tachycardia database from 2000 to 2006 identified 258 patients who had undergone radiofrequency ablation of focal AT. Ten patients were identified who had more than one sustained focal tachycardia at EP study, including seven patients with two ATs and three patients with three ATs. The patients were all women with a mean age of 54.2 ± 10.3 years. AT locations included the crista terminalis, coronary sinus ostium, tricuspid and mitral annuli, and pulmonary vein ostium. Successful ablation was performed for 22 (95.7%) of 23 tachycardias.ResultsDuring long-term follow-up of 32.7 ± 22.2 months, there were no recurrences of AT in those patients with successful ablation. No patients developed new AT foci, and only one developed late AF.ConclusionsWe have described a series of patients with multiple focal ATs with typical anatomic distribution. These patients do not have significant cardiac or respiratory disease, and in this series, all were women. This report demonstrates that up to three focal ATs can be successfully ablated at a single procedure without recurrence or development of other atrial arrhythmias in long-term follow-up.