title: Left atrial tachycardia in a patient with calcified coronary aneurysms due to Kawasaki disease.
abstract: Kawasaki disease (KD) is an acute vasculitis involving all blood vessels with frequent cardiovascular complications. We describe a 28-year-old patient with childhood KD having coronary complications at the age of 17 now presenting with sustained atrial tachycardia. Electrophysiological study and catheter ablation were performed. Electrophysiological study revealed a left atrial (LA) tachycardia (230 ms cycle length) with 2:1 atrioventricular node conduction. The mechanism for the arrhythmia was re-entry around the mitral annulus associated with the low-voltage scar area anterolateral to the annulus and juxtaproximal to the coronary artery calcification seen in fluoroscopy. We describe a patient with childhood KD presenting with LA re-entrant tachycardia associated with the atrial scar. The arrhythmia was successfully treated using radiofrequency catheter ablation.
authors.affiliation: National Heart and Lung Institute, Imperial College, Royal Brompton and Harefield Hospital, Sydney Street, London SW3 6NP, UK.
authors.forename: Paavo
authors.initials: P
authors.lastname: Uusimaa
authors.forename: Michala
authors.initials: M
authors.lastname: Pedersen
authors.forename: Tom
authors.initials: T
authors.lastname: Wong
authors.forename: Sabine
authors.initials: S
authors.lastname: Ernst
mesh_terms: D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology / Q000601:surgery; D002114:Calcinosis / Q000209:etiology* / Q000503:physiopathology; D017115:Catheter Ablation; D003323:Coronary Aneurysm / Q000209:etiology* / Q000503:physiopathology; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery; D004562:Electrocardiography; D006325:Heart Atria / Q000503:physiopathology; D006801:Humans; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000150:complications*; D009203:Myocardial Infarction / Q000601:surgery; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome