Nonautomatic focal atrial tachycardia: Characterization and ablation of a poorly understood arrhythmia in 38 patients

Janneke A E Kammeraad, Seshadri Balaji, Ronald P. Oliver, Sumeet S. Chugh, Blair D. Halperin, Jack Kron, John H. McAnulty

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Nonautomatic focal atrial tachycardia (NAFAT) is a rare and poorly understood arrhythmia either due to microreentry or triggered mechanism. NAFAT was defined as a focal atrial tachycardia which was inducible with pacing maneuvers in the electrophysiology lab. We reviewed the charts and EP study reports of all 38 patients with NAFAT, who underwent an EP study at our center between April 1994 and September 2000. Patients were predominantly female (n = 31, 82%), aged 11-78 years (median 46). The mean age at presentation was 31 years (range 7-71 years). None of the patients had structural heart disease or had undergone prior heart surgery. Electroanatomic mapping (EAM) was performed in 22 patients and showed no scars in the atrium. A total of 45 foci were identified (range 1-3 foci/patient). Anatomically NAFAT foci were predominantly right atrial (n = 35) rather than left (n = 10). The NAFAT cycle length ranged from 270 to 490 (mean ± SD; 380 ± 69 ms) and was significantly lower in patients younger than 24 years of age. Ablation, attempted for 42 foci was successful in 33 (79%). The success rate in the EAM group was 20/25 foci (80%) compared to 13/18 (72%) in the non-EAM group. In conclusion, NAFAT is a rare arrhythmia which predominantly affects women with no other associated cardiac disease. It mainly occurs in the right atrium, affects all ages and is amenable to catheter ablation.

Original languageEnglish (US)
Pages (from-to)736-742
Number of pages7
JournalPACE - Pacing and Clinical Electrophysiology
Volume26
Issue number3
DOIs
StatePublished - Mar 1 2003

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Tachycardia
Cardiac Arrhythmias
Heart Diseases
Catheter Ablation
Electrophysiology
Heart Atria
Thoracic Surgery
Cicatrix

Keywords

  • Atrial tachycardia
  • Catheter ablation
  • Electrophysiology
  • Focal

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Nonautomatic focal atrial tachycardia : Characterization and ablation of a poorly understood arrhythmia in 38 patients. / Kammeraad, Janneke A E; Balaji, Seshadri; Oliver, Ronald P.; Chugh, Sumeet S.; Halperin, Blair D.; Kron, Jack; McAnulty, John H.

In: PACE - Pacing and Clinical Electrophysiology, Vol. 26, No. 3, 01.03.2003, p. 736-742.

Research output: Contribution to journalArticle

Kammeraad, Janneke A E ; Balaji, Seshadri ; Oliver, Ronald P. ; Chugh, Sumeet S. ; Halperin, Blair D. ; Kron, Jack ; McAnulty, John H. / Nonautomatic focal atrial tachycardia : Characterization and ablation of a poorly understood arrhythmia in 38 patients. In: PACE - Pacing and Clinical Electrophysiology. 2003 ; Vol. 26, No. 3. pp. 736-742.
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abstract = "Nonautomatic focal atrial tachycardia (NAFAT) is a rare and poorly understood arrhythmia either due to microreentry or triggered mechanism. NAFAT was defined as a focal atrial tachycardia which was inducible with pacing maneuvers in the electrophysiology lab. We reviewed the charts and EP study reports of all 38 patients with NAFAT, who underwent an EP study at our center between April 1994 and September 2000. Patients were predominantly female (n = 31, 82{\%}), aged 11-78 years (median 46). The mean age at presentation was 31 years (range 7-71 years). None of the patients had structural heart disease or had undergone prior heart surgery. Electroanatomic mapping (EAM) was performed in 22 patients and showed no scars in the atrium. A total of 45 foci were identified (range 1-3 foci/patient). Anatomically NAFAT foci were predominantly right atrial (n = 35) rather than left (n = 10). The NAFAT cycle length ranged from 270 to 490 (mean ± SD; 380 ± 69 ms) and was significantly lower in patients younger than 24 years of age. Ablation, attempted for 42 foci was successful in 33 (79{\%}). The success rate in the EAM group was 20/25 foci (80{\%}) compared to 13/18 (72{\%}) in the non-EAM group. In conclusion, NAFAT is a rare arrhythmia which predominantly affects women with no other associated cardiac disease. It mainly occurs in the right atrium, affects all ages and is amenable to catheter ablation.",
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