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Found 1 result for Related Articles by Review for PMID: 39536147
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Electrophysiology Study and Ablation of Atrial Tachycardia

Ali Elsharkawi  1 , Sara A. Collier  2 , Intisar Ahmed  3
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.
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Electrophysiology Study and Ablation of Atrial Tachycardia

Ali Elsharkawi et al.
Free Books & Documents

Excerpt

Paroxysmal supraventricular tachycardias (PSVTs) affect approximately 36 out of 100,000 individuals annually in the United States, with women being twice as likely as men to develop the condition. The risk of PSVT increases significantly with age, with older individuals being 5 times more likely to experience the arrhythmia compared to younger people. PSVT accounts for 10% to 15% of cases in adults undergoing catheter ablation, while in children, it accounts for 10% to 20% of cases.

Focal atrial tachycardia (AT) is a supraventricular arrhythmia with rapid heart rates originating from ectopic atrial foci independent of the sinus or atrioventricular (AV) nodes, and it is a common mechanism of PSVT. Presenting as either unifocal or multifocal, AT has distinct pathophysiological mechanisms. Unifocal AT arises from enhanced automaticity, triggered activity, or micro-reentry mechanisms, resulting in a single, consistent P-wave morphology with an atrial rate of 150 to 250 bpm. Typically benign and paroxysmal, unifocal AT is often nonsustained. However, incessant tachycardia may cause tachycardia-induced cardiomyopathy.

On the other hand, multifocal atrial tachycardia (MAT) involves three or more distinct P-wave morphologies and an irregular atrial rate exceeding 100 bpm. Enhanced automaticity is the primary mechanism, with triggered activity also playing a role. MAT is frequently associated with underlying conditions such as pulmonary disease, metabolic imbalances, or drug effects.

Electrophysiology (EP) studies and catheter ablation are crucial for diagnosing and managing AT. Successful elimination of unifocal AT is frequently achieved through catheter ablation with low complication rates, while the management of MAT focuses on treating underlying causes. Advances in mapping technologies and ablation techniques have greatly enhanced outcomes for patients undergoing these procedures, making ablation a cornerstone in focal AT treatment. This review explores the mechanisms, diagnostic strategies, and therapeutic approaches, emphasizing the essential role of EP studies and ablation in contemporary cardiac care.

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Conflict of interest statement

Disclosure: Ali Elsharkawi declares no relevant financial relationships with ineligible companies.

Disclosure: Sara Collier declares no relevant financial relationships with ineligible companies.

Disclosure: Intisar Ahmed declares no relevant financial relationships with ineligible companies.

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