Focal atrial tachycardia: Reanalysis of the clinical and electrophysiologic characteristics and prediction of successful radiofrequency ablation

Introduction: Reports about the clinical and electrophysiologic characteristics of focal atrial tachycardia vary widely. Furthermore, the impact of age, gender, associated cardiac diseases, mechanism, location of atrial tachycardia, and the prediction of results of radiofrequency catheter ablation was not clear. The purpose of this study was to further understand the clinical and electrophysiologic characteristics of focal atrial tachycardia and the prediction of results of radiofrequency ablation. Methods and Results: We searched the literature published between January 1969 and July 1997 using the key word "atrial tachycardia" from the MEDLINE: and National Library of Medicine systems. The items analyzed were age, sex, cardiac disease, mechanism, attack pattern, cycle length, location, number of atrial tachycardias, results of ablation, and recurrence after ablation. Multivariate analysis showed that age and paroxysmal type of tachycardia were independent predictors of nonautomatic mechanism; age and presence of other cardiac diseases were independent predictors of multiple atrial tachycardias, and age also was the independent predictor of right-sided atrial tachycardia. Atrial tachycardia located in the right atrium was the only significant predictor of successful radiofrequency catheter ablation. Other cardiac diseases and multiple atrial tachycardias were the significant predictors of recurrence after initial successful radiofrequency catheter ablation. Conclusion: Patient age is closely related to the clinical and electrophysiologic characteristics of atrial tachycardia based on our reanalysis, which found that patient age is an independent predictor of nonautomatic mechanism, right atrial location, existence of multiple atrial tachycardias, and recurrence of atrial tachycardia after initial successful ablation.