Reentrant atrial tachycardia originating from the superior vena cava.
A 52-years old man with a previous pericardiotomy for idiopathic constrictive pericarditis underwent catheter ablation for drug-resistant atrial tachycardia (AT). The mechanism of the AT was considered as reentry because of resetting response and the entrainment phenomenon during AT. We introduced a 64-electrode basket catheter into the superior vena cava (SVC) during AT to obtain precise mapping. A fractionated potential preceding local atrial electrogram was recorded in the SVC. The earliest activation site of the potential was located at the anterior aspect of the SVC, 2 cm above the SVC-right atrium junction determined fluoroscopically. The fractionated potential at this site preceded the onset of the P wave by 115 msec. Radiofrequency catheter ablation at this site eliminated the tachycardia. At 6 months follow-up, the patient is free of AT. Reentrant AT involving the SVC is a candidate of RF ablation. Multielectrode basket catheter is useful for a detailed mapping of the SVC.
Okamoto
Kazuhiko
K
Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Sciences, Higashiku, Fukuoka, Japan 812-8582. h_ito@intmed1.med.kyushu-u.ac.jp
Ito
Hiroyuki
H
Kuma
Fumiaki
F
Koike
Akihiro
A
Shimoike
Eimei
E
Ueda
Norihiro
N
Maruyama
Toru
T
Kaji
Yoshikazu
Y
Fujino
Takehiko
T
D017115:Catheter Ablation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000503:physiopathology