[Incessant focal atrial tachycardia arising from the right appendage: risk of tachycardia mediated cardiomyopathy. Role of the radiofrequency ablation].
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Abstract:
Focal atrial tachycardias originate from different anatomic regions of the right atrium including the crista terminalis, the coronary sinus ostium, the tricuspid annulus, the interatrial septum and the right atrial appendage. The latter are characterized by being incessant and presenting poor response to antiarrhythmic treatment. They frequently evolve into tachycardiomyopathy and radiofrequency ablation is the treatment of choice. We present the case of a 36 month old girl with tachycardiomyopathy as a result of an incessant atrial tachycardia originated in the right atrial appendage. Patient underwent radiofrequency ablation.Keywords:
Crista terminalis
Fossa ovalis
Interatrial septum
Ostium
Atrial ectopic tachycardia is an incessant supraventricular tachycardia and is frequently refractory to medical treatment. Because it can cause tachycardia-induced cardiomyopathy, early diagnosis and treatment is important. We present a 16-year-old boy who was diagnosed as atrial ectopic tachycardia. The tachycardia, originating from the lower region of the right atrium along the crista terminalis was terminated by successful radiofrequency ablation treatment. The tachycardia did not recur in eight months of follow-up.
Crista terminalis
Supraventricular Tachycardia
Atrial tachycardia
Refractory (planetary science)
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The authors report a case of elimination of permanently recurring focal atrial tachycardia affecting the right atrial appendage by radiofrequency catheter ablation in a 20 year old serviceman.
Atrial Appendage
Atrial tachycardia
Appendage
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We report the case of a 71‐year‐old man with two atrial tachycardias evolving simultaneously and independently in two dissociated regions after extensive ablation for chronic atrial fibrillation. One tachycardia was a focal tachycardia originating from the right inferior pulmonary vein and activating the posterior left atrium with a 2:1 conduction block, while the other tachycardia was an atrial flutter circulating around the tricuspid annulus, activating the right atrium and the anterior wall of the left atrium. These two atrial tachycardias were successfully ablated prior to restoration of sinus rhythm.
Atrial tachycardia
P wave
Atrium (architecture)
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Catheter ablation of ectopic atrial tachycardia has been previously reported in a small number of patients in whom the ectopic focus was predominantly located in the right atrium. We report on a 51‐year‐old patient with atrial automatic tachycardia originating in the left atrium, in whom successful radiofrequency catheter ablation was pet formed via a transseptal puncture. The patient had suffered incessant atrial tachycardia for several years, refractory to antiarrhythmic drug treatment and DC‐cardioversion. Radiofrequency ablation terminated left ectopic atrial tachycardia and, therefore, should have been attempted before resorting to open heart surgical ablation.
Atrial tachycardia
Refractory (planetary science)
Radiofrequency catheter ablation
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Atrial tachycardia
Appendage
Atrial Appendage
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We present a rare case of tachycardiomyopathy in a 4-year-old girl. The child had incessant atrial tachycardia (AT) and refractory heart failure. Right atrial appendage (RAA) was localised as the source of the ectopic tachycardia. The child underwent successful radiofrequency ablation (RFA) using 3-D electroanatomical mapping. Fluoroscopy was used sparingly only to rule out underlying anomalies. The left ventricular functions returned to normal by one month after the procedure. RAA AT is rare in very young children and usually necessitates surgical appendectomies. RFA is a challenge in such age groups and there are very few published literature on RAA AT in very young children.
Atrial tachycardia
Refractory (planetary science)
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Atrial tachycardia
Appendage
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Focal atrial tachycardias originating from the left atrial appendage present unique anatomic challenges for successful ablation. We describe the role of minimally invasive percutaneous epicardial mapping and ablation in the management of two patients with ectopic atrial tachycardias arising from the left atrial appendage following failure of a conventional endocardial approach to achieve cure.
Appendage
Atrial Appendage
Atrial tachycardia
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Atrial tachycardia originating from the right atrial appendage has a higher probability of failure of catheter ablation. Here we report a case of a 13-year-old boy with incessant tachycardia, complicated by heart enlargement, and heart failure. Electrophysiological examination showed that atrial tachycardia (AT) originated from the apex of the right atrial appendage, and endocardial catheter ablation was ineffective. After thoracoscopic approach, the right atrial appendage was successfully ablated with bipolar radiofrequency ablation forceps, atrial tachycardia was terminated and sinus rhythm was restored. Within 3 months since the patient was discharged from the hospital, no arrhythmia occurred and the heart structure returned to normal. Thus, thoracoscopic clamp radiofrequency ablation may be a reasonable choice for young patients with atrial tachycardia originated from the right atrial appendage when transendocardial ablation is not effective.
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Atrial Appendage
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Crista terminalis
Atrial tachycardia
Crista
Reentry
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