Clinical Study of Catheter Ablation of Atrial Tachycardia Guided by Three Dimensional Mapping System

Objective:To evaluate the methods and effects of radiofrequency ablation of atrial tachycardia guided by CARTO.Methods:The atria of 40 cases were mapped by three dimensional electroanatomic mapping system.In order to analyse the mechanism of atrial tachycardia and perform the ablation of the earliest excited point in focal atrial tachycardia and isthmus in macroreentry atrial tachycardia.28 cases ablated by conventional procedure were selected as controlled group.The success rate and fluoroscopic time were compared between the two groups.Results:Focal atrial tachycardia was seen in 38 patients.The sites of origin from right atrium were at the coronary sinus ostium in 8 cases (20%),septal in 10 cases(25%),lateral wall in 8 cases(20%),superior vena cava ostium in 4 cases(10%),posterior wall in 4 cases(10%).One case had 3 types of atrial tachycardia(2.5%).The sites of origin from left atrium were at right pulmonary vein ostium in 1 case(2.5%),left pulmonary vein ostium in 1 case(2.5%),left auricular appendage in 1 case(2.5%).2 cases were macroreentry atrial tachycardia(5%).Ablation was performed successfully (100%) without any complication.No recurrence was found during a follow-up of 4-16 months.Success rate in conventional group was 89.3%(P0.05)。Comparing the CARTO group and conventional group,the fluoroscopic time was shorter,(13.8±5.5 ) min vs(30.4±12.9 ) min(P0.05).Conclusion:The mechanism of atrial tachycardia can be evaluated quickly and accurately.Ablation can be performed safely and effectively guided by CARTO.