Case Report| Volume 26, ISSUE 3, P208-211, September 2022

Prediction of PR interval prolongation after catheter ablation of incisional atrial tachycardia


      A three-dimensional (3D) mapping system is safe and effective for catheter ablation of incisional atrial tachycardia (IAT). Prolongation of the PR interval is occasionally observed after this procedure. Although a first-degree atrioventricular block is typically benign, an excessively prolonged PR interval can indicate a worse prognosis. Currently, a method to predict the PR interval after ablation therapy for IAT is lacking. We report the case of a 70-year-old woman with paroxysmal atrial tachycardia, in which our maneuver using a 3D mapping system and the electrophysiological findings enabled us to preoperatively predict the post-ablation PR interval. We believe that this method is useful for determining treatment strategies for IAT.

      Learning objective

      Three-dimensional (3D) mapping systems can clearly visualize macro-reentrant circuits and enable the creation of precise ablation lines. When creating ablation lines for incisional atrial tachycardia, attention should be paid to the prolongation of the PR interval, because an excessively prolonged PR interval may indicate a worse prognosis. Herein, we have presented a method for predicting the post-ablation PR interval using a 3D mapping system and electrophysiological findings.


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        • Liu X.Y.
        • Jacobsen P.K.
        • Pehrson S.
        • Chen X.
        Catheter ablation of incisional atrial tachycardia using remote magnetic navigation in patients after heart surgery: comparison between acquired and congenital heart disease.
        Europace. 2018; 20: ii33-9
        • Kwok C.S.
        • Rashid M.
        • Beynon R.
        • Barker D.
        • Patwala A.
        • Morley-Davies A.
        • et al.
        Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis.
        Heart. 2016; 102: 672-680
        • Bexton R.S.
        • Camm A.J.
        First degree atrioventricular block.
        Eur Heart J. 1984; 5: 107-109
        • Aro A.L.
        • Anttonen O.
        • Kerola T.
        • Junttila M.J.
        • Tikkanen J.T.
        • Rissanen H.A.
        • et al.
        Prognostic significance of prolonged PR interval in the general population.
        Eur Heart J. 2014; 35: 123-129
        • European Society of Cardiology (ESC)
        • European Heart Rhythm Association (EHRA)
        • Brignole M.
        • Auricchio A.
        • Baron-Esquivias G.
        • Bordachar P.
        • et al.
        2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA).
        Europace. 2013; 15: 1070-1118
        • Nogami A.
        • Kurita T.
        • Abe H.
        • Ando K.
        • Ishikawa T.
        • Imai K.
        • et al.
        JCS/JHRS 2019 guideline on non-pharmacotherapy of cardiac arrhythmias.
        J Arrhythm. 2021; 37: 709-870
        • Ono K.
        • Iwasaki Y.K.
        • Akao M.
        • Ikeda T.
        • Ishii K.
        • Inden Y.
        • et al.
        JCS/JHRS 2020 guideline on pharmacotherapy of cardiac arrhythmias.
        Circ J. 2022;