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Radio frequency Catheter Ablation of Sustained Intraatrial Reentrant Tachycardia in a Patient With Mirror‐Image Dextrocardia
Author(s) -
WU TSUJUEY,
CHEN SHIHANN,
CHIANG CHERNEN,
YANG CHINJUEY,
CHENG CHENCHUAN,
WANG SHIHPU,
CHIANG BENJAMIN N.,
CHANG MAUSONG
Publication year - 1994
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.1994.tb01203.x
Subject(s) - medicine , dextrocardia , tachycardia , cardiology , catheter ablation , reentry , ablation , atrial tachycardia , radiofrequency ablation , anesthesia
RF Catheter Ablation in Dextrocardia. Introduction: There has been limited experience with radio frequency catheter ablation in patients with Dextrocardia. This report describes a 37‐year‐oid man who had corundum type Atrial septal defect, mirror‐image Dextrocardia, and drug‐refractory Atrial tachycardia, in whom catheter‐mediated radio frequency energy successfully eliminated the tachycardia without complication. Methods and Results: On electrophysiologica study, the Atrial tachycardia could be induced and terminated by Atrial extra stimulation or rapid Atrial pacing. Mixed resetting response pattern and manifest entrainment were also demonstrated. These findings suggested that the mechanism of atrial tachycardia might be related to reentry with an excitable gap. Because of the mirrorimage dextrocardia, biplane fluoroscopy was adjusted to the right anterior oblique (RAO) 60°G and left anterior oblique (LAO) 30° positions. Inducibility of the tachycardia was completely abolished after the sixth application of radiofrequency current (30 W). It was noted that the successful electrogram preceded the onset of P wave during Atrial tachycardia by about 40 msec. Conclusion: This report presents another case in which radiofrequency catheter ablation was used in a patient with Dextrocardia. Atrial tachycardia in patients with congenital heart disease may be difficult to control pharmacologically; however, the use of radiofrequency catheter ablation could be recommended as an alternative to medication and surgery.