Adenosine-sensitive atrial tachycardia originating from the para-Hisian region with a slow conduction zone in the anteroseptal left atrium

Adenosine-sensitive atrial tachycardias (ATs) originating from the para-Hisian region have been reported, and their responsible mechanism is considered to be reentry. As an alternative strategy to ablation at the earliest activaton site (EAS) close to the atrioventricular node, previous reports safely eliminated these ATs at the entrance of the SCZ, indicated by a manifest entrainment-guided strategy, but no report has successfully ablated those ATs using the same strategy in the left atrium. We described a case of adenosine-sensitive AT originating from the para-Hisian region that could be eliminated at a remote site from the EAS indicated by the demonstration of manifest entrainment from the anteroseptal LA.