Klinik für Kardiologie, Angiologie und Pneumologie, II. Medizinische Klinik, Klinikum Coburg, Ketschendorfer Str. 33, 96450, Coburg, Germany.
Klinik für Kardiologie und internistische Intensivmedizin, Klinik für Kardiologie, Asklepios Klinik St. Georg, Hamburg, Germany.
Clin Res Cardiol. 2018 May;107(5):430-436. doi: 10.1007/s00392-018-1204-8. Epub 2018 Jan 17.
Catheter ablation of focal atrial tachycardia (FAT) can be a challenging procedure and results have been rarely described. The purpose of this study was to determine the characteristics and results of FAT ablation in the large cohort of the German Ablation Registry.
The German Ablation Registry is a nationwide prospective multicenter database including 12566 patients who underwent an ablation procedure between 2007 and 2010. Among them 431 (3.4%) underwent an FAT ablation and 413 patients with documented locations were analyzed. Patients were divided into three groups according to the FAT location: biatrial (BiA, n = 31, 7.5%), left atrial (LA, n = 110, 26.5%), and right atrial (RA, n = 272, 66%).
Acute success rate was 84% (68 vs. 85 vs. 85% in biA, LA, and RA, respectively, p = 0.038). 4.8% of patients had an early recurrence during hospitalization, most in biatrial location (p < 0.001). No major acute complication occurred. At 12 months, 81% were asymptomatic or improved. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) was 3.7%. Arrhythmia freedom without antiarrhythmic drugs was 58% and was lower in biA (34 vs. 56% in LA vs. 62% in RA, p = 0.019). Early recurrence during hospitalization was an outstanding predictive factor for recurrence during follow-up.
In this large patient population, FAT ablation had a relatively high acute success rate with a low complication rate. During follow-up, the recurrence rate was high, particularly in biatrial location. This was frequently predicted by an early recurrence during hospitalization.
导管消融局灶性房性心动过速（FAT）可能是一项具有挑战性的操作，相关结果鲜有报道。本研究的目的是在德国消融登记处的大样本中确定 FAT 消融的特点和结果。
德国消融登记处是一个全国性的前瞻性多中心数据库，包含 2007 年至 2010 年间接受消融治疗的 12566 例患者。其中 431 例（3.4%）行 FAT 消融，分析了 413 例有记录部位的患者。根据 FAT 部位将患者分为三组：双心房（BiA，n=31，7.5%）、左心房（LA，n=110，26.5%）和右心房（RA，n=272，66%）。
急性成功率为 84%（分别为 68%、85%和 85%，BiA、LA 和 RA 组间比较，p=0.038）。住院期间早期复发率为 4.8%，BiA 部位患者中最为常见（p<0.001）。无重大急性并发症发生。12 个月时，81%的患者无症状或改善。主要不良心血管和脑血管事件（MACCE）发生率为 3.7%。无抗心律失常药物治疗的心律失常无复发率为 58%，BiA 部位患者较低（LA 组为 56%，RA 组为 62%，BiA 组与 LA 组比较，p=0.019）。住院期间早期复发是随访期间复发的显著预测因素。
在本大样本患者中，FAT 消融的急性成功率相对较高，并发症发生率较低。随访期间复发率较高，特别是在双心房部位。这在住院期间的早期复发中经常得到预测。
