Abstract
Focal atrial tachycardia (AT) is a relatively uncommon form of arrhythmia. 10% of supraventricular tachycardia are due to AT. It can be diagnosed in a patient without any structural heart disease, however in the elderly, cardiovascular disease is often present. We report a rare occurence of focal atrial tachycardia, proven on three dimensional (3D) electrophysiology mapping of the heart in a 44-years-old woman with underlying mixed connective tissue disease and chronic rheumatic heart disease who was successfully treated with radiofrequency ablation. Primary question remained unanswered whether the arrythmia could be linked to her underlying disease, or purely a coincidental finding.
Highlights
Mixed Connective Tissue Disease (MCTD) was first described in 1972
A 44-years-old lady with a background history of mixed connective tissue disease (MCTD) diagnosed in 1992 with overlap syndrome of rheumatoid arthritis, systemic lupus erythematosus, and scleroderma fulfilling the proposed criteria of MCTD by Alarcon-Segovia and Kahn’s presented to our outpatient clinic for further management of arrhythmia. She has been managed by her rheumatologist prior to this since 1992 when she first presented with history of multiple joint pains and swelling, early morning stiffness lasting more than three hours, mouth ulcers, Raynaud’s phenomenon, digital vasculitis, early sclerodactyly, telengieactasia and puckering of angle of mouth
Upon reevaluation of these criteria by Amigues et al it is concluded that the criteria that best define MCTD were those proposed by Alarcon-Segovia, with 62.5% sensitivity and 86.2% specificity, and this is comparable to Kahn’s criteria [5]
Summary
Mixed Connective Tissue Disease (MCTD) was first described in 1972. It consist of mixed features of several autoimmune in origin connective tissue disorders such as Systemic Lupus Erythematosus (SLE), Systemic Sclerosis (SS), Polymyositis and Rheumatoid Arthritis (RA), in association with the presence of high titer of autoantibody to U1 ribonucleoprotein RNP [1]. A 44-years-old lady with a background history of mixed connective tissue disease (MCTD) diagnosed in 1992 with overlap syndrome of rheumatoid arthritis, systemic lupus erythematosus, and scleroderma fulfilling the proposed criteria of MCTD by Alarcon-Segovia and Kahn’s presented to our outpatient clinic for further management of arrhythmia. She has been managed by her rheumatologist prior to this since 1992 when she first presented with history of multiple joint pains and swelling, early morning stiffness lasting more than three hours, mouth ulcers, Raynaud’s phenomenon, digital vasculitis, early sclerodactyly, telengieactasia and puckering of angle of mouth. Previous medications (digoxin, bisoprolol, and pradaxa) was stopped and she was planned for review in two months’ time
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
