Cited by 212Cardiac Arrhythmias and TreatmentsAtrial Fibrillation Management and OutcomesCardiac electrophysiology and arrhythmias

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Characterization of Reentrant Circuits in Left Atrial Macroreentrant Tachycardia: Critical Isthmus Block Can Prevent Atrial Tachycardia Recurrence

Ouyang, Feifan, Ernst, Sabine, Vogtmann, Thomas, Goya, Masahiko, Volkmer, Marius, Schaumann, Anselm, Bänsch, Dietmar, Antz, Matthias, Kuck, Karl-Heinz·2002·Circulation

DOI 10.1161/01.cir.0000015077.12680.2e

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Abstract

BACKGROUND: Left atrial macroreentrant tachycardia (LAMRT) has not been characterized in detail. METHODS AND RESULTS: Twenty-eight patients with LAMRT, including 4 patients with ablated typical atrial flutter (AFL), underwent electroanatomic mapping of the left atrium (LA) between February 1999 and October 2001. LA maps were performed during LAMRT in 26 patients and during sinus rhythm in 2 patients. Electrically silent areas or continuous lines of double potentials were identified as acquired anatomic barriers in all patients. In 23 of 26 patients with LAMRT mapping, 42 reentry circuits with a protected isthmus were identified. The isthmus was 11.8+/-5.9 mm wide, with the maximal amplitude of 0.07 to 3.61 mV. Radiofrequency pulses terminated all LAMRTs in 23 patients and resulted in conduction block across the isthmus in 20 patients. In 2 patients with sinus mapping, all identified isthmuses were ablated. Additionally, AFL was induced and ablated in 6 patients. Atrial tachycardia recurred in 4 patients: 3 patients without validated block across the isthmus presented with recurrence of the same LAMRT, and 1 patient without ablated cavotricuspid isthmus presented with AFL. All tachycardias were abolished during a second procedure. Of 25 patients with identified isthmuses, 20 patients were without atrial arrhythmia and 5 had only atrial fibrillation during a median follow-up of 14 months. CONCLUSION: The reentry circuit with a protected isthmus can be identified in 89% patients with LAMRT by electroanatomic mapping. The isthmuses were amenable to radiofrequency applications in most patients. No atrial tachycardia recurred in any patients with isthmus block.

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10.1161/circ.101.6.631 · DOI
10.1161/circ.103.5.699 · DOI
10.1161/circ.103.16.2060 · DOI
10.1161/circ.101.25.2928 · DOI
10.1161/circ.91.8.2264 · DOI
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Authors: Ouyang, F., Ernst, S., Vogtmann, T., Goya, M., Volkmer, M., Schaumann, A., Bänsch, D., Antz, M., & Kuck, K.-H.
Affiliations: Asklepios Klinik St. Georg (DE)
From the II Med Abteilung, Allgemeines Krankenhaus St Georg, Hamburg, Germany.
ORCID: Ouyang, Feifan
Ernst, Sabine
Goya, Masahiko
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2002-04-23
Volume: 105
Issue: 16
Pages: 1934-1942
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/01.cir.0000015077.12680.2e
OpenAlex: W2004367293
Cited by: 212
References: 14
Citations by year: 2026: 1 · 2025: 5 · 2024: 8 · 2023: 2 · 2022: 7 · 2021: 12 · 2020: 5 · 2019: 13 · 2018: 4 · 2017: 16 · 2016: 7 · 2015: 6 · 2014: 6 · 2013: 7 · 2012: 17
FWCI: 7.46
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
Keywords: reentrant circuit, electroanatomical mapping, atrial flutter, radiofrequency catheter ablation, conduction block, atrial tachycardia recurrence, atrial fibrillation
MeSH terms: Adolescent, Adult, Aged, Arrhythmias, Cardiac, Atrial Flutter, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mitral Valve, Radiography, Tachycardia, Ectopic Atrial, Catheter Ablation, Body Surface Potential Mapping, Secondary Prevention

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Characterization of Reentrant Circuits in Left Atrial Macroreentrant Tachycardia: Critical Isthmus Block Can Prevent Atrial Tachycardia Recurrence

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