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Radiofrequency Catheter Ablation of Sinus Node Reentrant Tachycardia
Author(s) -
SPERRY ROBERT E.,
ELLENBOGEN KENNETH A.,
WOOD MARK A.,
BELZ MICHAEL K.,
STAMBLER BRUCE S.
Publication year - 1993
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1993.tb01027.x
Subject(s) - medicine , tachycardia , cardiology , ablation , catheter ablation , radiofrequency ablation , supraventricular tachycardia , atrial tachycardia , anesthesia , atrium (architecture) , atrial fibrillation
Sinus node reentrant tachycardia is a relatively uncommon (5%‐5%) form of recurrent paroxysmal supraventricular tachycardia (SVT). We describe a case of symptomatic sinus node reentrant tachycardia in a 67‐year‐old male with ischemic heart disease, congestive heart failure, and depressed ventricular function. Adenosine administered during an electrophysiology study caused prolongation of the tachycardia cycle length due to atrial cycle length prolongation (without atrio‐His prolongation) prior to tachycardia termination. Right atrial mapping revealed the earliest site of atrial activation in the high lateral right atrium just below the superior vena cava. Low energy (10 and 20 W) radiofrequency lesions were applied ai this site with termination of the tachycardia within 3 seconds of radiofrequency energy delivery. Tachycardia could not be reinduced after delivery of the radiofrequency lesions. The sinus node function immediately and 6 weeks after radiofrequency catheter ablation remained normal and the patient was without clinical recurrence of SVT. Mapping of sinus node reentrant tachycardia and elimination of the reentrant circuit with radiofrequency catheter ablation is possible without causing sinus node dysfunction. Adenosine causes prolongation of the atrial cycle length followed by termination of sinus node reentrant tachycardia.