Abstract
Unexplained Irreversible Sudden Termination of an Atypical Atrial Tachycardia for Atrial Fibrillation - What is the Mechanism?
Highlights
Four electrode catheters were inserted via the right femoral and cervical veins, and positioned in the coronary sinus (6Fr 20 pole catheter), high right atrium (5Fr quadripolar catheter), right ventricular apex (5Fr quadripolar catheter), and His bundle region (5Fr 10 pole catheter)
The earliest activation site was recorded around the coronary sinus (CS) ostium, which coincided with the onset of the P wave on the 12 lead ECG
The documented tachyarrhythmia was firstly suspected to be a focal atrial tachycardia (AT), we realized the course of the AT was consistent with that of a counter clockwise rotating cavo-tricuspid isthmus dependent atrial flutter
Summary
Four electrode catheters were inserted via the right femoral and cervical veins, and positioned in the coronary sinus (6Fr 20 pole catheter), high right atrium (5Fr quadripolar catheter), right ventricular apex (5Fr quadripolar catheter), and His bundle region (5Fr 10 pole catheter). The additional tricuspid isthmus line between tricuspid valve and inferior vena cava (IVC) was created, and the presence of atrial double potentials was confirmed. During the mapping procedure in the right atrium, a sudden AT termination without the following inducibility (bump) occurred.
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