Ultra-high-density mapping and ablation strategy for multiple scar-related right atrial tachycardias in patients without previous cardiac surgery

Catheter ablation of right atrial (RA) tachycardia in patients who have extensive spontaneous RA scarring is challenging due to the complex substrate and the potential for multiple inducible atrial tachycardias (ATs).Eighteen patients with scar-related RA AT and no prior cardiac surgery were enrolled. A total of 52 different ATs (mean 3.2 ± 1.5 ATs per patient) were observed. We endeavored to complete activation maps for 45 ATs.By analyzing activation maps, we classified ATs into six categories. The discrepant location and extension of ESAs were associated with different AT mechanisms.Multiple scar-related RA ATs were observed in patients without previous cardiac surgery. The detailed activation patterns of these ATs could be clearly demonstrated by using an ultra-high-density mapping system.