title: Focal atrial tachycardia refractory to radiofrequency catheter ablation originating from right atrial appendage.
abstract: A 44-year-old female presented with incessant, drug-refractory atrial tachycardia (AT). An electrophysiological study suggested focal abnormal automaticity, and localized the AT origin to the apex of the right atrial appendage (RAA). Repeated radiofrequency catheter ablation to the site of the earliest endocardial activation during AT failed. At surgery, right atrial appendectomy terminated the AT. On macroscopic findings, the cavity of the RAA became a dead-end before the apex. In patients with drug and radiofrequency catheter ablation, refractory focal AT arising from the RAA, especially the apex of the RAA, in our opinion surgical treatment could be considered in the lack of efficacy of ablation.
authors.affiliation: The First Department of Internal Medicine, Niigata University School of Medicine, 1-754 Asahi-machi-dori, Niigata 951-8510, Japan. chimiri@med.niigata-u.ac-jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furushima
authors.forename: Masaomi
authors.initials: M
authors.lastname: Chinushi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Hosaka
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
mesh_terms: D000328:Adult; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D020517:Atrial Appendage / Q000503:physiopathology / Q000601:surgery*; D017115:Catheter Ablation; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D013612:Tachycardia, Ectopic Atrial / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents