Open AccessMicro-reentry right atrial tachycardia originating from fossa ovalis: a case report of high-density mapping by PentaRay catheter
Author(s) -
Jin-yi Li,
Xiangwei Lv,
Guoqiang Zhong,
Honghong Ke
Publication year - 2019
Publication title -
european heart journal. case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.256
H-Index - 5
ISSN - 2514-2119
DOI - 10.1093/ehjcr/ytz141
Subject(s) - reentry , ablation , tachycardia , medicine , fossa ovalis , cardiology , atrial tachycardia , catheter ablation , palpitations , atrial fibrillation , reentrancy , computer science , left atrium , programming language
Background Micro-reentry tachycardia usually emerges in scar tissues related to post-atrial fibrillation ablation and cardiomyopathy. It is difficult to identify the micro-reentry circuit accurately by conventional mapping method. Case summary A 74-year-old man presented with paroxysmal atrial tachycardia (AT) presenting as palpitations. He was evaluated by an electrophysiological examination using a high-density CARTO mapping system. The mapping results showed the AT with a cycle length of 184 ms was focused on his right atrial fossa ovalis (FO). In this small area, the high-density mapping demonstrated a significant micro-reentrant tachycardia. Radiofrequency ablation at the centre of the micro-reentrant circuit successfully terminated the AT. No recurrences were observed during a 12-month follow-up. Discussion This case demonstrated a micro-reentrant AT originates from the FO without cardiomyopathy or previous ablation with specific loops. This is an unusual location for AT though and can cause difficulty for operators if it terminates or is non-sustained. High-density mapping using a PentaRay catheter can effectively characterize micro-reentrant circuits and determine the real target for ablation therapy.