The occurrence of left atrial tachycardias
(AT) after catheter ablation for atrial fibrillation (AF) are common, especially
after more extensive ablation of persistent AF. These AT are invariably
symptomatic and often do not respond to medical therapy. The initial strategy involves ventricular
rate control, cardioversion, and observation as some tachycardias may resolve
with time. For persistent ATs, effective management frequently requires
catheter intervention. Careful characterization of the tachycardia mechanism is
essential in designing an effective ablation strategy that would also avoid
further creation of pro-arrhythmic substrate. With this review, we
summarize the incidence, mechanism, diagnosis and treatment of ATs occurring
after AF ablation.
Credits: Stavros Mountantonakis, MD; Edward P. Gerstenfeld, MD