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Successful Ablation of Atrial Tachycardia in the Right Coronary Cusp of the Aortic Valve in a Patient with Atrial Fibrillation: What is the Substrate?
Author(s) -
GAMI APOOR S.,
VENKATACHALAM K.L.,
FRIEDMAN PAUL A.,
ASIRVATHAM SAMUEL J.
Publication year - 2008
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.1540-8167.2007.01094.x
Subject(s) - medicine , cusp (singularity) , cardiology , ablation , atrial fibrillation , intracardiac injection , aortic valve , tachycardia , coronary sinus , atrial tachycardia , catheter ablation , geometry , mathematics
Atrial tachycardias have been successfully ablated from the noncoronary cusp of the aortic valve. The anatomical substrate responsible for the arrhythmia in these patients is unknown. We report a case of intracardiac ultrasound confirmed ablation in the right coronary cusp of the aortic valve. Pacing maneuvers performed in this case, along with the regional anatomy of the right coronary cusp, strongly suggest that the ablated substrate is muscular extensions above the aortic valve. Ablation in the right coronary cusp eliminated tachycardia without valve damage or AV conduction abnormality.