Limitations of 12-lead electrocardiogram wide complex tachycardia algorithms in a patient with left atrial flutter and large myocardial infarction Carlos.

Slides:

Advertisements

Similar presentations

Volume 4, Issue 1, Pages (January 2007)

Advertisements

Wolff-Parkinson-White syndrome due to a left atrial appendage–to–left ventricular connection: A case of a successful pathway elimination from inside of.

Incessant bundle branch reentrant ventricular tachycardia in a patient with corrected transposition of the great arteries Ken Kato, MD, Daigo Yagishita,

Successful ablation of premature ventricular contractions originating from the inferoseptal process of the left ventricle using a coronary sinus approach

Volume 11, Issue 1, Pages (January 2014)

Volume 13, Issue 10, Pages (October 2016)

HeartRhythm Case Reports

Peri–coronary sinus atrial flutter associated with prior slow pathway ablation Mitsunori Maruyama, MD, PhD, FHRS, Shunsuke Uetake, MD, PhD, Yasushi Miyauchi,

Challenges in the diagnosis and management of idiopathic ventricular fibrillation Jonathan Lipton, MD, PhD, George J. Klein, MD, Raymond W. Sy, MBBS,

A case of scar-related ventricular tachycardia demonstrating termination with nonglobal capture at the site of concealed entrainment with dual slow conduction.

Two mechanisms of termination of idiopathic reentrant ventricular tachycardia originating from the left coronary cusp/right coronary cusp commissure with.

Irregular wide QRS complex tachycardia in a patient with pulmonary hypertension: What is the mechanism? Abigail Louise D. Te, MD, Fa-Po Chung, MD, Yenn-Jiang.

Maged F. Nageh, MD,FHRS, Kamal Kotak, MD HeartRhythm Case Reports

Cardiac inflammation and ventricular tachycardia in Chagas disease

Claudio Hadid, MD, Sergio Gonzalez, MD, Jesús Almendral, MD, PhD

Dual-loop biatrial concomitant macroreentrant tachycardia in a patient without previous history of surgery or ablation Song-Yun Chu, MD, Li-Bin Shi,

Perimitral atrial flutter associated with a protected coronary sinus after a Maze IV procedure and concomitant mitral annulus repair Gaku Kanda, MD,

Microreentrant left atrial tachycardia circuit mapped with an ultra-high-density mapping system Fu Siong Ng, MRCP, PhD, Fernando Guerrero, BSc, Vishal.

Atrial fibrillation originating from recipient left atrium after an orthotopic heart transplantation Auroa Badin, MD, Jaret Tyler, MD, FHRS, Steven J.

Pseudo typical atrial flutter occurring after cavotricuspid isthmus ablation in a patient with a prior history of Senning operation Naoki Yoshida, MD,

Isolation of the conduction between the Marshall bundle and distal coronary sinus and the entire coronary sinus for an atrial tachycardia after catheter.

Bradley D. Brochu, MD, Ahmed Abdi-Ali, MD, Jeffrey Shaw, MD, F

Swallowing-induced atrial tachycardia arising from superior vena cava: Significant involvement of parasympathetic nerve activity Koji Higuchi, MD, PhD,

Incessant intraseptal ventricular tachycardia ablated utilizing extracorporeal membrane oxygenation and bipolar ablation Ali B.A.K. Al-Hadithi, BA(Hons),

Successful catheter ablation using real-time ultrasound-assisted 3-D electroanatomical mapping system for atrioventricular accessory pathway in a 1-year-old.

An unusual atrioventricular accessory pathway with an oblique course

Adenosine-sensitive atrial tachycardia originating from the anterior mitral annulus Dai Inagaki, MD, Rintaro Hojo, MD, Seiji Fukamizu, MD, PhD, Harumizu.

A case of successful termination of an atrial tachycardia ablated from the pulmonary artery during rapid ventricular pacing Toshiya Kurotobi, MD, PhD,

Pseudo-conduction block at the mitral isthmus in a patient with epicardial impulse propagation through the vein of Marshall Rintaro Hojo, MD, Seiji Fukamizu,

Cardiac arrest in an adolescent with Uhl’s anomaly: Two unusual cardiac arrhythmia mechanisms Jeffrey P. Moak, MD, Gail D. Pearson, MD, ScD, Bradley.

Single-catheter validation of bidirectional block during atrial flutter ablation Piotr Futyma, MD, Marian Futyma, MD, PhD, Konrad Dudek, MD, Piotr Kułakowski,

Macroreentrant form of an adenosine 5′-triphosphate–sensitive atrial tachycardia arising from the vicinity of the atrioventricular node involving the.

Focal atrial fibrillation presenting in the origin of atrial tachycardia Chin-Yu Lin, MD, Yenn-Jiang Lin, MD, Fa-Po Chung, MD, Shih-Ann Chen, MD HeartRhythm.

Mindy Vroomen, MD, Mark La Meir, MD, Harry J

Cryoablation of an atrioventricular nodal reentrant tachycardia in a patient with an implanted deep brain stimulator Melanie Gunawardene, MD, Christian.

Expanding the electrical phenotype of NKX2-5 mutations: Ventricular tachycardia, atrial fibrillation, and complete heart block within one family Simone.

Dual intraventricular response after cardiac resynchronization

An unusual approach to intractable AVNRT in a pediatric patient

Tina Baykaner, MD, MPH, Joshua M. Cooper, MD, FHRS

Electroanatomical high-density mapping of different tachycardias in the right atrium after heart transplantation Alexandra Schratter, MD, Valentina Schirripa,

Atrial Tachycardia in a Patient With Fabry’s Disease

Overcoming left bundle branch block by permanent His bundle pacing: Evidence of longitudinal dissociation in the His via recordings from a permanent pacing.

Bundle branch reentry: A novel mechanism for sustained ventricular tachycardia in Chagas heart disease Alvaro V. Sarabanda, MD, PhD, Wagner L. Gali,

Mapping of a postinfarction left ventricular aneurysm–dependent macroreentrant ventricular tachycardia Elad Anter, MD, Jianqing Li, MD, Cory M. Tschabrunn,

An unusual cause of lone atrial fibrillation in a young female subject due to a rapid- cycling focal atrial trigger Shankar Baskar, MD, Mehran Attari,

Biatrial flutter circuit involving an anomalous insertion of the Bachmann bundle into the superior vena cava Ely Gracia, MD, Roger Fan, MD, FHRS HeartRhythm.

Radiofrequency ablation of common atrial flutter via right subclavian/jugular vein access in a patient with bilateral lower limb venous obstruction: Importance.

Hiroko Asakai, MD, Laura Fenwick, BSc, Robert M. Hamilton, MD, FRCP(C)

Circular mapping recordings in a persistent left superior vena cava during atrial tachycardia: Was isolation achieved? Sandrine Venier, MD, Jason G.

Successful catheter ablation of idiopathic ventricular tachycardia originating from the top of the left ventricular posterior papillary muscle near the.

Successful treatment of tachycardia-induced cardiomyopathy secondary to dual atrioventricular nodal nonreentrant tachycardia using cryoablation Harold.

A case of an incision-related single-loop intra-atrial reentrant tachycardia showing an eccentric atrial activation sequence and widely separate potentials.

Utility of entrainment pacing to clarify the circuit of macroreentrant tachycardia with dual early sites on activation maps Koichi Nagashima, MD, PhD,

Abnormal atrial strain with speckle-tracking echocardiography predicts the arrhythmic substrate of atypical right atrial flutter Hiroshi Kawakami, MD,

Successful fluoroless ablation of an incessant atypical atrial flutter attributed to AtriClip usage during mini-MAZE surgery for persistent atrial fibrillation

Colin Yeo, MBBS, Martin S. Green, MD, Girish M

Colin Yeo, MBBS, Martin Green, MD, Robert Lemery, MD, FHRS

Clinical and electrophysiological features of respiratory cycle–dependent atrial tachycardia: An analysis of three cases Osamu Inaba, MD, Junichi Nitta,

Peter Kabunga, MBChB, MRCP, George J. Klein, MD, FHRS, Raymond W

Mahaim pathway tachycardia versus bystander ventricular tachycardia: A distinction without a difference Michael S. Wu, MD, James E. Ip, MD, FHRS, George.

Clinical problem solving: Maneuvering around a narrow complex tachycardia in a patient with Mustard repair for transposition of the great arteries Nicholas.

Getting to the right left atrium: Catheter ablation of atrial fibrillation and mitral annular flutter in cor triatriatum Ryan T. Borne, MD, Jaime Gonzalez,

Successful catheter ablation of focal ventricular tachycardia originating from right bundle branch without making right bundle branch block, using pharmacologic.

Two apparently remote types of ventricular tachycardia from a single right bundle branch focal source Jaromír Josiek, MD, Jaroslav Januška, MD, PhD,

Catheter ablation for the treatment of persistent atrial fibrillation: Maintenance of sinus rhythm with left atrial appendage and coronary sinus isolation.

Ablation of a symptomatic spontaneous automatic focus arising from an atriofascicular fiber Sandrine Venier, MD, Paul Khairy, MD, PhD, Bernard Thibault,

Left atrial access via an unroofed coronary sinus to eliminate fast/slow atypical AVNRT: A case report Gustavo X. Morales, MD, Yousef H. Darrat, MD,

Jeffrey Munro, DO, Win-Kuang Shen, MD, FHRS, Komandoor Srivathsan, MD

Atrial flutter following ethanol infusion in the vein of Marshall

A wide QRS complex tachycardia utilizing an atypical accessory pathway in latent Wolff- Parkinson-White syndrome: Manifestation of anterograde conduction.

Presentation transcript:

Limitations of 12-lead electrocardiogram wide complex tachycardia algorithms in a patient with left atrial flutter and large myocardial infarction Carlos Macias, MD, Houman Khakpour, MD, Eric Buch, MD, Kalyanam Shivkumar, MD, PhD, Jason S. Bradfield, MD HeartRhythm Case Reports Volume 5, Issue 2, Pages 70-73 (February 2019) DOI: 10.1016/j.hrcr.2018.04.001 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 A: The 12-lead electrocardiogram (ECG) during wide complex tachycardia (WCT) showing atypical right bundle branch block and R wave in lead aVR. B: The 12-lead ECG during WCT with occasional narrow QRS complexes, possibly consistent with capture beats C: The 12-lead ECG during sinus rhythm after termination of WCT. HeartRhythm Case Reports 2019 5, 70-73DOI: (10.1016/j.hrcr.2018.04.001) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 A: Surface leads and intracardiac tracing during wide complex tachycardia showing atrial flutter (AFL) with cycle length of 220 ms and ventricular cycle length of 440 ms. B: Following 24 mg of intravenous adenosine, AFL persists despite atrioventricular node (AVN) block. Note surface electrocardiogram during AVN block shows 2 beats of narrow complex QRS (second and third QRS complex) with precordial Q waves similar to narrow complexes in Figure 1B. C: Entrainment of AFL from the left atrial roof shows concealed fusion with a postpacing interval (PPI)–tachycardia cycle length (TCL) of 4 ms. D: Entrainment of AFL from CS3,4 (distal CS) shows PPI–TCL of 39 ms. ABL = ablation; CS = coronary sinus; HIS = His catheter proximal (p), mid (m), and distal (d). HeartRhythm Case Reports 2019 5, 70-73DOI: (10.1016/j.hrcr.2018.04.001) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 A: Right anterior oblique fluoroscopic view demonstrating the position of the AtriClip left atrial appendage (LAA) exclusion system (AtriCure, Mason, OH) with red arrows. Circular mapping catheter is in the left superior pulmonary vein (LSPV). Ablation catheter tip is at the location where atrial flutter (AFL) terminated during ablation (asterisk). B: Activation map of AFL showing propagation up the posterior left atrial wall and down the anterior wall. Brown dots show sites of ablation and green dot is the site of AFL termination. C: ABL d shows fractionated continuous signal on ABL distal positioned at the anterosuperior LAA/LSPV ridge (adjacent to AtriClip) at the site of AFL termination. D: Termination of atrial flutter with resumption of sinus rhythm. ABL = ablation; CS = coronary sinus. HeartRhythm Case Reports 2019 5, 70-73DOI: (10.1016/j.hrcr.2018.04.001) Copyright © 2018 Heart Rhythm Society Terms and Conditions