Low right atrial tachycardia with positive P waves in the inferior leads: explanation by electroanatomical mapping.
The P-wave morphology can help trying to localize the origin of an ectopic atrial tachycardia noninvasively. We describe the case of a 54-year-old male patient with an ectopic right atrial tachycardia and positive P waves in the inferior leads on a 12 lead ECG. Electroanatomical mapping with the CARTO system localized the focus at the low right atrial free wall. With that origin and a very slow conduction through the cavotricuspid isthmus the activation spread clockwise around the tricuspid anulus and resulted in a craniocaudal septal activation pattern, which subsequently caused a positive P-wave morphology in the inferior leads.
Arya
Arash
A
Department of Electrophysiology, Heart Center, University of Leipzig, Strümpellstrasse 39, 04289, Leipzig, Germany. dr.arasharya@gmail.com
Kottkamp
Hans
H
Piorkowski
Christopher
C
Hindricks
Gerhard
G
D018780:Body Surface Potential Mapping / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis*