Radiofrequency catheter ablation of atrial tachycardia under navigation using the EnSite array

Abstract

Background: Atrial tachycardia (AT) is sometimes difficult to eliminate by radiofrequency ablation (RFA), but the EnSite array (EA) visualizes the beat-to-beat virtual activation of any tachycardia. Methods and Results: The 51 patients with 74 ATs (mean age 57±18 years, 28 males) undergoing EA-guided RFA were included; 14 patients had had previous open heart surgery and 5 had organic heart disease. RFA was performed at the AT focus for focal AT (n=48) with an endpoint of AT termination and subsequent non-inducibility. RFA was performed at a critical conducting pathway for reentrant AT (n=26) with creation of a block line in the critical reentry circuit. EA revealed that 57 ATs originated in the right atrium (77%) and 17 originated in the left atrium (23%); all but 1 were successfully eliminated. Fluoroscopic time was 19±11 min, the number of RFA applications was 8±7, and the radiofrequency energy was 10,711±12,655 J. No complications were noted. All but 2 patients were free of any symptoms during a follow-up of 16±9 months. Conclusions: EA-guided RFA is safe and effective for AT, irrespective of its mechanism, sustainability or origin, and regardless of underlying heart disease.