Dual-loop intra-atrial re-entry tachycardia in a patient with ischaemic cardiomyopathy.
A 65-year-old man with ischaemic cardiomyopathy (three prior coronary artery bypass surgery procedures), underwent catheter ablation for recurrent atrial flutter. Electrophysiological study initially revealed clockwise, tricuspid annulus/inferior vena cava isthmus dependent, atrial flutter. During radiofrequency energy ablation atrial flutter changed into a different atrial tachycardia without change in cycle length or interruption of the tachycardia. The new tachycardia was a right atrial free wall re-entry tachycardia. Thus the two atrial tachycardias formed a dual-loop ('figure-of-eight') re-entry circuit, possibly due to atrial scar tissue from multiple cardiac surgery procedures.
University of Arizona Health Sciences Center, Department of Medicine, Sarver Heart Center, Tucson 85724, USA. ottp@u.arizona.edu
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D000368:Aged; D001282:Atrial Flutter / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications*