The Role Of Non-coronary Cusp Ablation Approach In The Treatment Of Perinodal Atrial Tachcardias:Preferential Or Adjunctive?

Objective Ablation in the noncoronary aortic cusp (NCC) potentially has a role in the treatment of perinodal atrial tachycardias (ATs).The objective of the study was to characterize the role of NCC ablation in the treatment of perinodal ATs among a cohort of patients with perinodal ATs.Methods A total of one hundred and thirteen patients with focal ATs who underwent electrophysiologic study and radiofrequency catheter ablation were enrolled in the study.The electrophysiological characteristics and the target electrograms of those who need NCC ablation and other patients of perinodal ATs were compared.Results Totally20cases were revealed to have the focal ATs located in the perinodal area. Among them, only five cases (25%) warranted ablation in the NCC, whereas the remainder could be successfully eliminated by ablation from the endocardial right atrium at the perinodal region.There were no clinical and electrophysiological clues observed to have the potential to predict the true original site, including the activation mode, the three dimensional mapping characteristics of earliest activation site in the right atrium, as well as the time of termination during the ablation in the perinodal area.Conclusions Approximately one fourth of the perinodal ATs need ablation in the NCC.However, no clinical and electrophysiological clues could predict the true origin site of the perinodal ATs.The NCC ablation may serve as an adjunctive role in the catheter ablation treatment of the perinodal ATs.