INTRODUCTION
The advent of high-density mapping has considerably facilitated the
diagnosis and treatment of atrial tachycardia (AT). Macroreentrant
circuit and bursting focus are at both ends of the mechanistic spectrum
and thus necessitate opposite ablation strategies. Perimitral,
roof-dependent, and cavotricuspid isthmus (CTI)-dependent flutters can
be efficiently treated with a linear lesion blocking an anatomical
isthmus. Whereas focal ATs require a patchy lesion targeting the source,
which most often corresponds to the earliest electrical activity. At the
crossroads has recently emerged a category of AT showing centrifugal
propagation, while the underlying mechanism is, in fact,
macroreentry.1 This comes along with a better
understanding of the key role of distinct atrial epicardial
structures.2 Identifying these ”pseudo-focal” ATs is
crucial in order to opt for the appropriate ablation strategy.
The present study is a retrospective analysis of pseudo-focal ATs, with
specific emphasis on the anatomical substrates, electrophysiological
properties, and ablation outcomes.