Radiofrequency Ablation of Focal Atrial Tachycardia Originated From Left Coronary Cusp
Focal atrial tachycardias (ATs) can originate anywhere in either atria and their appendages and the aortic root.However, to our knowledge, there has been less report of an AT originated from LCC.Patient Characteristics and Electrophysiological Study A 35-year-old woman with paroxysmal palpitations and refractory to treatment with antiarrhythmic drugs (AADs) referred to our department.The twelve-lead ECG recorded during the episodes showed the P-wave morphology.A sustained atrial tachycardia (AT) with 3∶2 atrioventricular conduction was observed throughout EP study by intravenous isoproterenol infusion, and EnSite Array (EA) simultaneously reconstructing three-dimensional (3D) images of right atrium (RA) demonstrated that the AT originated sites were clustered at the right atrial septum which was reconfirmed with NavX system.After intensive activation mapping at this region, the earliest atrial activation site was para-His bundle (HB) merely preceded of the P wave onset in the surface ECG by 22 ms.Considering AT possibly to arise from the left atrium (LA), mapping in the aortic cusp was performed to identify a potential focus of the tachycardia after transseptal puncture failed to assess the LA.The aortography demonstrated the earlist atrial potential recorded inside the left coronary cusp (LCC) preceded the P-wave onset in the surface ECG by 41 ms,and earlier than that of the noncoronary cusp (NCC) and HB.The radiofrequency energy with power 40 W and maximum temperature of 55 ℃ delivered at this site terminated the AT in 5 seconds, and without AT spontaneous or inducible by isoproterenol infusion.No recurrence was observed with 24h Holter recordings during a three-month follow-up without any antiarrhythmic drugs.
HUIMIN CHU XIAOMIN CHEN CAIJIE SHEN BIN HE
Department of Cardiology, Ningbo First Hospital, 59 St.Liuting, 315000 Ningbo, PR China
国内会议
杭州
英文
445-446
2011-07-28（万方平台首次上网日期，不代表论文的发表时间）