A novel pacing maneuver to localize focal atrial tachycardia

MOHAMED, UWAIS; SKANES, ALLAN C.; GULA, LORNE J.; LEONG‐SIT, PETER; KRAHN, ANDREW D.; YEE, RAYMOND; SUBBIAH, RAJESH; KLEIN, GEORGE J.

doi:10.1111/j.1540-8167.2006.00664.x

Cited by 164Cardiac Arrhythmias and TreatmentsCardiac electrophysiology and arrhythmiasCardiac pacing and defibrillation studies

A novel pacing maneuver to localize focal atrial tachycardia

MOHAMED, UWAIS, SKANES, ALLAN C., GULA, LORNE J., LEONG‐SIT, PETER, KRAHN, ANDREW D., YEE, RAYMOND, SUBBIAH, RAJESH, KLEIN, GEORGE J.·2007·Journal of Cardiovascular Electrophysiology

DOI 10.1111/j.1540-8167.2006.00664.x

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Abstract

BACKGROUND: Although focal atrial tachycardias cannot be entrained, we hypothesized that atrial overdrive pacing (AOP) can be an effective adjunct to localize the focus of these tachycardias at the site where the post-pacing interval (PPI) is closest to the tachycardia cycle length (TCL). METHODS: Overdrive pacing was performed in nine patients during atrial tachycardia, and in a comparison group of 15 patients during sinus rhythm. Pacing at a rate slightly faster than atrial tachycardia in group 1 and sinus rhythm in group 2 was performed from five standardized sites in the right atrium and coronary sinus. The difference between the PPI and tachycardia or sinus cycle length (SCL) was recorded at each site. The tachycardia focus was then located and ablated in group 1, and the atrial site with earliest activation was mapped in group 2. RESULTS: In both groups the PPI-TCL at the five pacing sites reflected the distance from the AT focus or sinus node. In group 1, PPI-TCL at the successful ablation site was 11 +/- 8 msec. In group 2, PPI-SCL at the site of earliest atrial activation was 131 +/- 37 msec (P < 0.001 for comparison). In groups 1 and 2, calculated values at the five pacing sites were proportional to the distance from the AT focus or sinus node, respectively. CONCLUSIONS: The PPI-TCL after-AOP of focal atrial tachycardia has a direct relationship to proximity of the pacing site to the focus, and may be clinically useful in finding a successful ablation site.

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Atrial overdrive pacing can localize the focus of focal AT because the post-pacing interval increases with increasing distance from the source.
“Atrial overdrive pacing can be used to localize the focus of these tachycardias, since the PPI increases with increasing distance from the source.100”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [100]

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Authors: MOHAMED, U., SKANES, A. C., GULA, L. J., LEONG‐SIT, P., KRAHN, A. D., YEE, R., SUBBIAH, R., & KLEIN, G. J.
Affiliations: Western University (CA)
ORCID: SKANES, ALLAN C.
GULA, LORNE J.
LEONG‐SIT, PETER
KRAHN, ANDREW D.
YEE, RAYMOND
SUBBIAH, RAJESH
KLEIN, GEORGE J.
Venue: Journal of Cardiovascular Electrophysiology
Publisher: Wiley
Published: 2006-11
Volume: 18
Issue: 1
Pages: 1-6
ISSN: 1045-3873 (ISSN-L)
1540-8167
DOI: 10.1111/j.1540-8167.2006.00664.x
OpenAlex: W2024059333
Cited by: 164
References: 31
Citations by year: 2025: 1 · 2024: 1 · 2020: 4 · 2019: 6 · 2018: 3 · 2017: 6 · 2016: 7 · 2015: 5 · 2014: 12 · 2013: 13 · 2012: 15
FWCI: 13.81
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Journal of Cardiovascular Electrophysiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
Keywords: focal atrial tachycardia, atrial overdrive pacing, tachycardia cycle length, sinus cycle length, catheter ablation, right atrium, coronary sinus, sinoatrial node, atrial activation mapping
MeSH terms: Cardiac Pacing, Artificial, Electrocardiography, Follow-Up Studies, Heart Rate, Humans, Tachycardia, Ectopic Atrial, Treatment Outcome

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A novel pacing maneuver to localize focal atrial tachycardia

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