title: Histological examination of the right atrial appendage after failed catheter ablation for focal atrial tachycardia complicated by cardiogenic shock in a post-partum patient.
abstract: A 26-year-old woman in her first pregnancy presented with persistent atrial tachycardia (AT). AT was resistant to medications, cardioversions, and the first attempt of catheter ablation. Two months after delivery she developed severe systolic dysfunction and circulatory collapse. Emergent catheter ablation was performed with the support of percutaneous cardiopulmonary bypass and intraaortic balloon pump. The AT originated in the apex of the right atrial appendage (RAA). Repeated attempts at ablation were unsuccessful, prompting surgical RAA resection, which terminated the tachycardia and improved the cardiac function. Histological examination of resected RAA provided insights into mechanism of resistance to catheter ablation.
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Mizukami
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Yokohama Minami Kyousai Hospital, 1-21-1 Mutsuurahigashi, Kanazawa-ku, Yokohama, Kanagawa 236-0037, Japan.
authors.forename: Rena
authors.initials: R
authors.lastname: Nakamura
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kuroda
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Maki
authors.initials: M
authors.lastname: Ono
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Matsue
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Iwatsuka
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Taishi
authors.initials: T
authors.lastname: Yonetsu
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Matsumura
authors.affiliation: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Hashimoto
keywords: Atrial tachycardia; Cardiogenic shock; Histology; Pregnancy; Right atrial appendage