Native left atrial tachycardias clinical and electrophysiological characteristics: insights from a national survey

Abstract Background Native left atrial tachycardias (ATs), - in the absence of atriotomy or previous left atrial (LA) ablations- are rare observations. Purpose We aimed to analyze the clinical and electrophysiological characteristics of native left ATs from a National survey, especially the occurrence of atrial fibrillation (AF) in these patients during the follow-up. Methods From Jan 2023 to Dec 2023, a questionnaire was electronically sent to French electrophysiologists in order to analyze the characteristics of native left ATs. Patients with previous history of AF, and/or previous atriotomy, and/or previous LA ablation were excluded from this study. Results 39 patients were included: 71 ± 10 years; male 66.7 %, structural heart disease 61.5 %. The culprit circuit was localized in 30.7 % and macroreentrant in 61.5 % of the cases, around an anterior scar present in 53.8 %. The initial ablation strategy consisted in pulmonary vein isolation in the majority of the cases (23/39), and LA lines creation in 30/39 (76.9 %). Initial ablation procedure was considered successful in all. 8/39 (20.5 %) patients underwent a second procedure. After a mean follow-up of 21 ± 22 months, 13/39 (33.4 %) patients presented AT recurrences with infrequent AF recurrence (1 patient out of 39). Conclusion In this specific group of patients with native left ATs, ablation strategy is associated with a high acute success rate, with 33 % AT recurrences during the follow-up, but without significant AF recurrences.Native left atrial tachycardia