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Exit Block of Focal Repetitive Activity in the Superior Vena Cava Masquerading as a High Right Atrial Tachycardia
Author(s) -
INO TAKESHI,
MIYAMOTO SHINJIRO,
OHNO TADAAKI,
TADERA TAKESHI
Publication year - 2000
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.1540-8167.2000.tb00346.x
Subject(s) - medicine , atrial tachycardia , superior vena cava , cardiology , atrial fibrillation , tachycardia , ablation , catheter ablation , sinus rhythm , p wave , atrium (architecture)
AT Originating from the SVC. An unusual case of atrial tachycardia (AT) originating from the superior vena cava (SVC) is reported. A 34‐year‐old man without structural heart disease underwent catheter ablation for drug‐resistant AT. During the tachycardia, low‐amplitude spiky electrograms with a cycle length of 120 to 175 msec were recorded in the SVC and exhibited 2:1 exit block to the atria, masquerading as the atrial activation observed with high right AT. These spiky electrograms also were observed during sinus rhythm, but they appeared immediately after the local atrial electrograms. The spikes were traced to a point 3 cm above the junction of the right atrium. Radiofrequency ablation at the site of the earliest appearance of the spike in the SVC successfully eliminated the tachycardia. During the following 15 months, no clinically significant atrial arrhythmias, including atrial fibrillation, occurred. This report indicates that careful mapping, including inside the SVC, will be a requisite in patients with high right atrial tachyarrhythmias.