Prevalence and Characteristics of Atrial Tachycardia from Noncoronary Aortic Cusp during Atrial Fibrillation Catheter Ablation

Myung Jin Cha, Jun Kim, Yoon Jung Park, Min Soo Cho, Hyoung Seob Park, Soonil Kwon, Young Soo Lee, Jinhee Ahn, Hyung Oh Choi, Jong Sung Park, You Mi Hwang, Jin Hee Choi, Ki Won Hwang, Yoo Ri Kim, Seongwook Han, Seil Oh, Gi Byoung Nam, Kee Joon Choi, Hui Nam Pak

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Background and Objectives: Atrial tachycardias (ATs) from noncoronary aortic cusp (NCC) uncovered after radiofrequency ablation for atrial fibrillation (AF) are rarely reported. This study was conducted to investigate the prevalence and clinical characteristics of NCC ATs detected during AF ablation and compare their characteristics with de novo NCC ATs without AF. Methods: Consecutive patients who underwent radiofrequency catheter ablation for AF were reviewed from the multicenter AF ablation registry of 11 tertiary hospitals. The clinical and electrophysiological characteristics of NCC AT newly detected during AF ablation were compared with its comparators (de novo NCC AT ablation cases without AF). Results: Among 10,178 AF cases, including 1,301 redo ablation cases, 8 (0.08%) NCC AT cases were discovered after pulmonary vein isolation (PVI; 0.07% in first ablation and 0.15% in redo ablation cases). All ATs were reproducibly inducible spontaneously or with programmed atrial stimulation without isoproterenol infusion. The P-wave morphological features of tachycardia were variable depending on the case, and most cases exhibited 1:1 atrioventricular conduction. AF recurrence rate after PVI and NCC AT successful ablation was 12.5% (1 of 8). Tachycardia cycle length was shorter than that of 17 de novo ATs from NCC (303 versus 378, p=0.012). No AV block occurred during and after successful AT ablation. Conclusions: Uncommon NCC ATs (0.08% in AF ablation cases) uncovered after PVI, showing different characteristics compared to de-novo NCC ATs, should be suspected irrespective of P-wave morphologies when AT shows broad propagation from the anterior interatrial septum.

Original languageEnglish
Article numbere48
Pages (from-to)513-526
Number of pages14
JournalKorean Circulation Journal
Publication statusPublished - 2022 May

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© 2022.

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine


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