To explore the incidence, risk factors, electrophysiological features, and clinical outcomes of intra-procedural atrial tachycardia (IAT) during radiofrequency catheter ablation (RFCA) for paroxysmal atrial fibrillation (PAF), highlighting its clinical significance.
Key Findings:
IAT occurred in 13.33% of patients, indicating a significant occurrence during RFCA.
Right atrial enlargement was an independent risk factor (OR = 1.14, P = 0.015), emphasizing the need for monitoring.
Types of AT included peri-tricuspid (45%), peri-mitral (45%), roof-dependent (2.5%), and focal (7.5%), which are crucial for targeted interventions.
12-month sinus rhythm maintenance rate was 78.0%, with no significant difference between AT and non-AT groups (79.4% vs. 77.8%, P = 0.84), suggesting similar long-term outcomes.
Interpretation:
IAT is relatively common during PAF ablation, primarily due to macro-reentrant circuits around the tricuspid and mitral annuli, with right atrial diameter being a key predictor, highlighting the need for careful monitoring and management.
Limitations:
Single-center study may limit generalizability and introduce potential biases.
Exclusion criteria may affect the applicability of findings to broader populations, necessitating further research.
Conclusion:
With successful intra-procedural identification and targeted ablation, patients with IAT can achieve similar long-term outcomes as those without IAT, underscoring the importance of effective management strategies.
