Occurrence of Focal Atrial Tachycardia During the Ablation Procedure Is Associated With Arrhythmia Recurrence After Termination of Persistent Atrial Fibrillation

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Catheter ablation is widely performed for paroxysmal and persistent atrial fibrillation (AF).1 Stepwise ablation strategy has been developed for persistent AF, in which electrogram‐based ablation and linear ablation are performed in addition to PV isolation, with the procedural endpoint of termination of AF by ablation.2 During stepwise ablation, atrial tachycardias (ATs) commonly occur immediately after termination of AF, requiring ablation.2 Stepwise ablation strategy is recognized as an aggressive strategy, and recurrence of AF is unusual following this strategy if AF was terminated by ablation. However, 28–45% of patients do have recurrence of AT during follow‐up.5 As a result, nearly half of them require repeat ablation for maintenance of sinus rhythm. The mechanism by which AT occurs after the ablation procedure needs to be elucidated to improve the clinical outcome of stepwise ablation. The first aim of this retrospective study was to determine the association between types of ATs occurring during stepwise ablation for persistent AF and rate of freedom from atrial tachyarrhythmias (AF or AT) during follow‐up. The second aim was to assess whether type of ATs occurring during the ablation procedure was associated with the mechanism of recurrent atrial tachyarrhythmias.
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