Long-term outcome following successful catheter ablation of atrial tachycardia originating from the pulmonary veins: absence of late atrial fibrillation.

Objectives: This study aimed to characterize the long-term outcome and incidence of atrial fibrillation (AF) in patients following catheter ablation of focal atrial tachycardia (AT) from the pulmonary veins (PV).
Background: Although both AT and AF may originate from ectopic foci within PVs, it is unknown whether PV AT patients subsequently develop AF.
Methods: Twenty-eight patients with 29 PV ATs (14%) from a consecutive series of 194 patients who underwent RFA for focal AT were included. Patients with concomitant AF prior to the index procedure were excluded.
Results: The minimum follow-up duration was 4 years; mean age 38 +/- 18 years with symptoms for 6.5 +/- 10 years, having tried 1.5 +/- 0.9 antiarrhythmic drugs. The distribution of foci was: left superior 12 (41%), right superior 10 (34%), left inferior 5 (17%), and right inferior 2 (7%). The focus was ostial in 93% and 2-4 cm distally within the vein in 7%. Mean tachycardia cycle length was 364 +/- 90 ms. Focal ablation was performed in 25 of 28 patients. There were 6 recurrences with 5 from the original site. Twenty-six patients were available for long-term clinical follow-up. At a mean of 7.2 +/- 2.1 years, 25 of 26 (96%) were free from recurrence off antiarrhythmic drugs. No patients developed AF.
Conclusions: Focal ablation for tachycardia originating from the PVs is associated with long-term freedom from both AT and AF. Therefore, although PV AT and PV AF share a common anatomic distribution, PV AT is a distinct clinical entity successfully treated with focal RFA and not associated with AF in the long term.