The efficacy of radiofrequency catheter ablation in ectopic atrial tachycardia

Background: Ectopic atrial tachycardia (EAT) is a relatively rare form of supraventricular arrhythmia, which, if persistent, may lead to tachycardia-induced cardiomyopathy (TIC), associated with an equally poor prognosis, including the risk of sudden cardiac death, as other dilated cardiomyopathies. The aim of the study was to evaluate the efficacy and course of radiofrequency catheter ablation (RFCA) in the treatment of patients with EAT. Methods: The study group comprised 33 consecutive patients (16 males and 17 females of mean age 41 ± 15 years) managed for EAT at our clinic. Each patient underwent an electrophysiological study (EPS) and atrial mapping during an episode of arrhythmia using the CARTO system. Subsequent RFCA was undergone by 32 patients. The procedure was considered successful if the arrhythmia terminated during energy application and remained non-inducible by isoprenaline. The mean follow-up period was 23 ± 13 months.Results: The ectopic focus was localised in the right atrium in 29 patients (88%) and in the left atrium in 5 patients (15%). In 6 patients more than one ectopic focus was found. The mean duration of the procedure was 159 ± 67 min and the mean duration of fluoroscopy was 25 ± 15 min. In 32 patients undergoing RFCA for the first time (the first session), the efficacy was 97%. In 2 patients with a recurrence of tachycardia and in 3 patients with EAT caused by another ectopic focus a re-ablation was performed (the second session) with an efficacy of 80%. The patient in whom re-ablation was unsuccessful underwent a third RFCA (third session). The total efficacy was 97%. Conclusions: Radiofrequency catheter ablation is an effective and safe treatment in patients with ectopic atrial tachycardia