![]() The exclusion criteria were: prior ablation of atrial tachycardia (AT) or atrial fibrillation (AF) malfunction of valve prosthesis presence of left atrial thrombus detected by transesophageal echocardiography decompensated heart failure concomitant AF at the time of enrollment unable to provide written informed consent. The inclusion criteria were: repetitive or sustaining MAT occurred > 2 months post-valve surgery failure of one or more antiarrhythmic drugs (AADs) therapy or unwilling to take AADs. The diagnosis of MAT was primarily based on rapid and regular atrial activity with monomorphic P wave (or flutter wave) on standard twelve-lead electrocardiograms (ECG) and consistent atrial activation sequence on endocardial recording. Of note, the surgical technique might vary between centers and therefore, the findings of this study might not be generalized to all patients with status post valve surgery arrhythmias.įorty-eight patients (29 males, average age 56.1 ± 13.3 years) with the history of tricuspid or mitral valve surgery in Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine were enrolled consecutively to undergo catheter ablation of MAT from April 2013 to December 2019. This retrospective study was carried out to explore the electrophysiological characteristics of MAT and the effectiveness of MAT ablation in patients with tricuspid or mitral valve surgery. However, there is paucity of data regarding the difference in the electrophysiological characteristics of MATs after tricuspid or mitral valve surgery, and the effectiveness of MAT ablation in these patients has not been adequately investigated. In contrast to tricuspid valve surgery, mitral valve surgery involves inter-atrial septum incision and left atriotomy rather than right atriotomy, which might produce septal and left atrial MATs instead of right atrial MATs. Due to the complex substrate and coexistence of multiple reentries, catheter ablation of MATs in this scenario is often challenging and is associated with compromised long-term results. Atriotomy, suture and fibrotic scars provide an ideal substrate for MATs. Macro-reentrant atrial tachycardias (MATs) can occur in a considerable proportion of patients early or late after cardiac valve surgery. Trial registration: This study was registered as a part of EARLY-MYO-AF clinical trial at the website ClinicalTrials. ConclusionĪlthough the types of MATs differed significantly in patients with prior TV or MV surgery, the acute and mid-term effectiveness of MAT ablation was comparable in two groups. No predictor for recurrence was identified. 76.5%) was comparable in TV and MV group. 93.3%) and the one-year freedom from atrial tachy-arrhythmias (72.2 vs. The acute success rate of MAT ablation (100 vs. 84.2%), higher prevalence of left atrial MAT (35.9 vs.5.3%) and higher proportion of patients with left atrial MAT (40 vs. Compared with TV group, MV group had significantly lower prevalence of CTI-dependent AFL (38.5% vs. Thirty-nine MATs were identified in MV group, including15 CTI-dependent AFL, 8 RA free wall scar-related, 2 RA septum scar-related, 8 peri-mitral flutter, 3 LA roof-dependent, 2 LA anterior scar-related, and 1 right pulmonary vein-related MAT. Nineteen MATs were documented in TV group, including 16 cavo-tricuspid isthmus (CTI)-dependent AFL and 3 other MATs at right atrial (RA) free wall, RA septum and left atrial (LA) roof. The one-year clinical effectiveness was compared in two groups. MATs were mapped and ablated guided by a three-dimensional navigation system. Methodsįorty-eight patients (29 males, age 56.1 ± 13.3 years) with MAT after valve surgery were assigned to tricuspid valve (TV) group (n = 18) and mitral valve (MV) group (n = 30). Data comparing the electrophysiological characteristics and the ablation results of MAT post-tricuspid or mitral valve surgery are limited. The MAT types and the effectiveness of MAT ablation might differ after different valve surgery. Macro-reentrant atrial tachycardias (MATs) are a common complication after cardiac valve surgery.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |