[Fulguration of foci of atrial tachycardia in the adult].
Fulguration of the site generator of arrhythmia was attempted in three 31, 33 and 55 year-old patients presenting ectopic atrial tachycardias resistant to various antiarrhythmic medications. Episodes of atrial fibrillation and flutter were also documented in two of them. Two patients had a surgically corrected congenital cardiopathy:interatrial communication or pulmonary stenosis. Mapping of the endocardial emergence point was carried out with electrodes placed 1 cm apart, demonstrating the high atrial origin of the tachycardia, near the right atrium. The auriculogram preceded the earliest possible ectopic P wave by 20 to 70 ms; its multiphasic and prolonged morphology, suggested a local intra-atrial conduction disorder in the three cases. Cathodic shocks were delivered at this site without complications with cumulative energies of 720 J, 480 J and 320 J, respectively. The fulguration was ineffective and revealed other arrhythmic sites in two patients. Only patient n1 has been asymptomatic since 24 months under a treatment with Sotalol 160 mg which had been previously ineffective.
D000328:Adult; D000818:Animals; D002648:Child; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D013612:Tachycardia, Ectopic Atrial / Q000628:therapy*; D013617:Tachycardia, Supraventricular / Q000628:therapy*
Fulguration des foyers de tachycardie atriale de l'adulte.