Ectopic atrial rhythm with exit block following catheter ablation for focal atrial tachycardias in a patient with prior surgery for atrial septal defect.
The patient was a 40-year-old woman with a history of surgery for atrial septal defect and catheter ablation for typical atrial flutter. An electrophysiological study was performed because she had palpitation and syncope. She had ectopic atrial rhythm originating from low lateral RA. Two focal atrial tachycardias ([1] superior vena cava-RA junction and [2] a lowposteroseptal RA) were successfully ablated. Following catheter ablation for the second atrial tachycardia, she developed junctional rhythm because ectopic atrial rhythm showed exit block. However, atrial activation of junctional rhythm could conduct into the ectopic atrial rhythm focus and reset the rhythm when atrial activation of junctional rhythm reached the blocked line after atrial refractoriness by preceding ectopic atrial rhythm.
Ohkubo
Kimie
K
Second Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Watanabe
Ichiro
I
Kojima
Toshiaki
T
Masaki
Riko
R
Oshikawa
Naohiro
N
Sugimura
Hidezou
H
Okumura
Yasuo
Y
Yamada
Takeshi
T
Saito
Satoshi
S
Ozawa
Yukio
Y
Kanmatsuse
Katsuo
K
D000328:Adult; D001282:Atrial Flutter / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects*; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006327:Heart Block / Q000209:etiology*; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications; D013612:Tachycardia, Ectopic Atrial / Q000209:etiology / Q000628:therapy*