Cor Vasa 2017, 59(4):e353-e358 | DOI: 10.1016/j.crvasa.2017.06.003

The incidence and types of atrial tachyarrhythmias occurring after hybrid ablation procedures

Pavel Osmančík^a,*, Petr Budera^b, Dalibor Heřman^a, Jana Ždárská^a, Radka Procházková^a, Zbyněk Straka^b

^a Kardiologická klinika, Kardiocentrum, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

^b Kardiochirurgická klinika, Kardiocentrum, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha, Česká republika

Background: Despite successful creation of box lesions during hybrid ablations, reoccurrence of atrial fibrillation (AF) and/or regular atrial arrhythmias (ATs) still occur. The goal of this study was to describe the incidence and types of regular ATs that occur after successful hybrid ablations.

Methods: Patients after hybrid ablation for persistent or long-standing persistent AF were enrolled. Patients, in whom regular AT occurred, were recommended for electrophysiological study and re-ablation. The mechanism of regular AT was described using activation and entrainment mapping.

Results: Regular AT occurred in 5 (10%) patients from 50 patients, in whom hybrid ablation has been performed. Peri-mitral flutter was found to be the mechanism of clinical AT in 4 patients, in the last patient, a typical right sided isthmus-dependent flutter was present. After ablation of the clinical arrhythmia, other ATs were inducible and ablated in two patients resulting in non-inducibility of any arrhythmia at the end of the procedure in all patients. All patients with regular AT were free of symptoms and free of any further tachyarrhythmia or AF during follow-up of 285 ± 122 days.

Conclusion: The incidence of regular AT in patients after hybrid ablation procedure was 10%, with the majority of them being associated with re-entry around the mitral annulus.

Keywords: Atrial fibrillation; Atrial tachycardia; Hybrid ablation; Long-standing persistent atrial fibrillation; Persistent atrial fibrillation

Received: May 7, 2017; Revised: June 1, 2017; Accepted: June 2, 2017; Published: August 1, 2017  Show citation