A unique iatrogenic organized left atrial tachycardia with a gap conduction in previously ablated lesions.
This case concerns a 57-year-old woman with an organized left atrial tachycardia (AT) after pulmonary vein (PV) isolation. The left inferior PV (LIPV) exhibited a figure of eight tachycardia around the LIPV ostium with one loop at the anterior aspect and another at the posterior aspect, which corresponded to regular surface P waves. Although a gap ablation of fractionated electrograms changed the LIPV sequence, the atrial potentials were organized with a shortened cycle length accompanied by the same surface P-wave morphology. The elimination of the anterior loop and modification of the posterior loop after the gap ablation might have yielded that specific sequence change of the AT.
Nakahara
Shiro
S
Department of Cardiology, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minami Koshigaya, Koshigaya, Saitama 343-8555, Japan. nshiro@dokkyomed.ac.jp
Seino
Masanori
M
Sakai
Yoshihiko
Y
Takayanagi
Kan
K
D004562:Electrocardiography; D005260:Female; D017629:Gap Junctions / Q000502:physiology; D006325:Heart Atria; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D007049:Iatrogenic Disease; D008875:Middle Aged; D013610:Tachycardia / Q000209:etiology* / Q000503:physiopathology*