title: Mapping and ablation of anteroseptal atrial tachycardia in patients with congenitally corrected transposition of the great arteries: implication of pulmonary sinus cusps.
abstract: OBJECTIVE
  We sought to investigate focal atrial tachycardias (ATs) in patients with congenitally corrected transposition of the great arteries (ccTGA).
  
  
  RESULTS
  We identified three cases of focal ATs with ccTGA from 2007 to 2015. The clinical findings, electrocardiography, electrophysiological features, and ablation were reported. All three cases had {S,L,L}-type ccTGA. The AT P waves shared the following features: narrow in width, positive in leads I and aVL, and negative/positive in lead V1. All ATs had focal activation pattern with early activation at the anteroseptal area, and further mapping demonstrated earliest atrial activation (EAA) inside the pulmonary sinus cusps (PSCs), especially the right PSC. In Cases 1 and 2, double potentials were recorded at the EAA sites. Conduction delay between the two potentials during atrial extrastimulus was observed. After successful ablation, the second potential during sinus rhythm was further delayed in Case 1 and was eliminated in Case 2. However, only one potential was recorded in Case 3. All three cases were successfully managed by ablating the sites with EAA, which preceded the P-wave onset by 60, 80, and 42 ms, respectively. During ablation, no junctional rhythm was observed. Incomplete left bundle branch block was induced during mapping in Case 1, but no other complications occurred. All patients were free from tachycardia during follow-up periods of 36, 7, and 5 months, respectively.
  
  
  CONCLUSIONS
  Anteroseptal AT in patients with ccTGA could be eliminated by ablation inside the PSC.
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Xiao-Gang
authors.initials: XG
authors.lastname: Guo
authors.affiliation: Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong, China.
authors.forename: Zili
authors.initials: Z
authors.lastname: Liao
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Liu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Gong-Bu
authors.initials: GB
authors.lastname: Zhou
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Jian-du
authors.initials: JD
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Luo
authors.affiliation: Department of Cardiology, Asklepios Klinik St. Georg, Hamburg, Germany.
authors.forename: Feifan
authors.initials: F
authors.lastname: Ouyang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Ma
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
authors.forename: Shu
authors.initials: S
authors.lastname: Zhang
mesh_terms: D000200:Action Potentials; D000293:Adolescent; D000328:Adult; D017115:Catheter Ablation / Q000009:adverse effects; D000080041:Congenitally Corrected Transposition of the Great Arteries; D004562:Electrocardiography; D022062:Electrophysiologic Techniques, Cardiac; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D012307:Risk Factors; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014188:Transposition of Great Vessels / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Atrial tachycardia; Congenitally corrected transposition of the great
                      arteries; Electroanatomical mapping; Pulmonary sinus cusp; Radiofrequency catheter ablation