Atrial tachycardia originating at the tricuspid annulus.
We report a patient with re-entrant atrial tachycardia that originated at the inferolateral tricuspid annulus. Single atrial extra-stimulation reproducibly induced the atrial tachycardia with an inverse relationship between the coupling interval of extra-stimulation and the return cycle of the first tachycardia beat. A real-time three-dimensional electroanatomical mapping showed focal atrial activation spreading semi-radially from the tricuspid annulus. The tachycardia was successfully eliminated by radiofrequency ablation at the earliest atrial activation site, preceding by 27 ms the arbitrary determined onset of surface P wave. An accelerated atrial rhythm with similar P-wave morphology to that of the tachycardia was observed at the successful ablation site during radiofrequency application. The mechanism of this tachycardia seems to be due to re-entry originating in or around the possible accessory atrioventricular node without ventricular connection.
Okuyama
Yuji
Y
Cardiovascular Division, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka, 543-0035, Japan. y-okuyama@oph.gr.jp
Mizuno
Hiroya
H
Oka
Takafumi
T
Komatsu
Sei
S
Hirayama
Atsushi
A
Kodama
Kazuhisa
K
D017115:Catheter Ablation; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D006801:Humans; D008297:Male; D008875:Middle Aged; D013610:Tachycardia / Q000503:physiopathology* / Q000601:surgery; D014261:Tricuspid Valve / Q000503:physiopathology*