Intraprocedural atrial tachycardia during ablation of paroxysmal atrial fibrillation: incidence, mechanisms, and clinical outcomes

Background: Radiofrequency catheter ablation (RFCA) is the mainstay treatment for paroxysmal atrial fibrillation (PAF). However, the incidence, risk factors, and impact of intra-procedural atrial tachycardia (IAT) during PAF ablation remain insufficiently characterized. The purpose of this study was to explore the incidence, risk factors, electrophysiological features, and clinical outcomes of IAT. Methods: In this single-center, prospective study, 255 patients undergoing RFCA for PAF were analyzed. IAT was defined as stable tachycardia lasting more than 2 min, either induced or spontaneous. Logistic regression identified risk factors for AT, and Kaplan-Meier analysis was used to examine its impact on long-term success. Results: = 0.84). Conclusions: IAT was observed in 13.3% of patients undergoing PAF ablation, with macro-reentrant circuits around the tricuspid and mitral annuli being the primary mechanisms. Right atrial diameter served as a key predictor. Our data demonstrate that with successful intra-procedural identification and targeted ablation, IAT patients can achieve a 12-month prognosis similar to non-IAT patients.