Zusammenfassung
Atriale Tachykardien nach interventioneller oder operativer Therapie des Vorhofflimmerns werden zunehmend zu einem Problem in der Rhythmologie. Sowohl die konservative als auch die interventionelle Therapie mittels Katheterablation sind eine Herausforderung. Der vorliegende Beitrag gibt eine Übersicht über die Pathophysiologie, die Diagnostik und das Management dieser meist iatrogenen Rhythmusstörungen.
Abstract
Atrial tachycardias occurring after catheter or surgical ablation of atrial fibrillation are a growing concern in clinical electrophysiology. Their management, either with drugs or with catheter ablation techniques, remains challenging. The present article gives an overview of the pathophysiology, diagnosis and management of these often iatrogenic and complex arrhythmias.
Literatur
Chugh A, Latchamsetty R, Oral H et al (2006) Characteristics of cavotricuspid isthmus-dependent atrial flutter after left atrial ablation of atrial fibrillation. Circulation 113:609–615
Chun KR, Bansch D, Ernst S et al (2007) Pulmonary vein conduction is the major finding in patients with atrial tachyarrhythmias after intraoperative maze ablation. J Cardiovasc Electrophysiol 18:358–363
Cummings JE, Schweikert R, Saliba W et al (2005) Left atrial flutter following pulmonary vein antrum isolation with radiofrequency energy: linear lesions or repeat isolation. J Cardiovasc Electrophysiol 16:293–297
Deisenhofer I, Estner H, Zrenner B et al (2006) Left atrial tachycardia after circumferential pulmonary vein ablation for atrial fibrillation: incidence, electrophysiological characteristics, and results of radiofrequency ablation. Europace 8:573–582
Gerstenfeld EP, Callans DJ, Sauer W et al (2005) Reentrant and nonreentrant focal left atrial tachycardias occur after pulmonary vein isolation. Heart Rhythm 2:1195–1202
Gerstenfeld EP, Dixit S, Bala R et al (2007) Surface electrocardiogram characteristics of atrial tachycardias occurring after pulmonary vein isolation. Heart Rhythm 4:1136–1143
Haissaguerre M, Hocini M, Sanders P et al (2006) Localized sources maintaining atrial fibrillation organized by prior ablation. Circulation 113:616–625
Jais P, Hocini M, Hsu LF et al (2004) Technique and results of linear ablation at the mitral isthmus. Circulation 110:2996–3002
Mcelderry HT, Mcgiffin DC, Plumb VJ et al (2008) Proarrhythmic aspects of atrial fibrillation surgery: mechanisms of postoperative macroreentrant tachycardias. Circulation 117:155–162
Mohamed U, Skanes AC, Gula LJ et al (2007) A novel pacing maneuver to localize focal atrial tachycardia. J Cardiovasc Electrophysiol 18:1–6
Ouyang F, Antz M, Ernst S et al (2005) Recovered pulmonary vein conduction as a dominant factor for recurrent atrial tachyarrhythmias after complete circular isolation of the pulmonary veins: lessons from double Lasso technique. Circulation 111:127–135
Sanders P, Hocini M, Jais P et al (2005) Characterization of focal atrial tachycardia using high-density mapping. J Am Coll Cardiol 46:2088–2099
Saoudi N, Cosio F, Waldo A et al (2001) A classification of atrial flutter and regular atrial tachycardia according to electrophysiological mechanisms and anatomical bases; a statement from a joint expert group from the working group of arrhythmias of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Eur Heart J 22:1162–1182
Shah D, Sunthorn H, Burri H et al (2006) Narrow, slow-conducting isthmus dependent left atrial reentry developing after ablation for atrial fibrillation: ECG characterization and elimination by focal RF ablation. J Cardiovasc Electrophysiol 17:508–515
Interessenkonflikt
Der korrespondierende Autor weist auf folgende Beziehungen hin: Der Autor PD Dr. Thomas Arentz hat Vortragshonorare der Firmen Biosense, Boston, Cryocath, Medtronic, Sanofi-Aventis und SJM erhalten.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Arentz, T., Herrera, C., Weber, R. et al. Atriale Tachykardien nach interventioneller oder operativer Therapie von Vorhofflimmern. Kardiologe 3, 126–133 (2009). https://doi.org/10.1007/s12181-008-0155-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12181-008-0155-0