Prevalence and predictive factors of left atrial tachycardia occurring after second‐generation cryoballoon ablation of atrial fibrillation

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Left atrial tachycardia (LAT) is one of the complications observed after percutaneous radiofrequency ablation of atrial fibrillation and is often more severely symptomatic than atrial fibrillation itself. The prevalence of LAT depends on the method used to isolate the pulmonary veins. LAT occurs in 2.9% of cases after segmental pulmonary vein ablation and is due to a focal source on reconnected veins in eight out of 10 cases.1 LAT is observed in 4% of patients after a circumferential ablation technique and, in this case, the predominant mechanism is macroreentrant tachycardia (61%) rather than focal tachycardia (37%).2 After isolation of both ipsilateral veins, LAT is observed in 26% of cases and is due to atriovenous reconnection in 70% of cases, nonostial ectopic activity in 13% of cases and left atrial macroreentrant tachycardia in 17% of cases.3 In the various published series of radiofrequency ablation, the prevalence of postprocedural LAT ranged between 10 and 43%.4 The prevalence of atrial tachycardia after cryoballoon ablation is between 0 and 4%, but no study has specifically described postcryoballoon ablation LAT (pcryo‐LAT). Atrial tachycardia is mainly due to atriovenous reconnection,6 while macroreentrant tachycardia was reported in only one study.9 The objectives of this study were to determine the prevalence and mechanism of pcryo‐LAT, their predictive factors and their clinical significance on long‐term outcome.
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