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.

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Date of download: 6/25/2016 Copyright © The American College of Cardiology. All rights reserved. From: Mechanism, localization and cure of atrial arrhythmias.

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Presentation transcript:

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 Case Reports Volume 1, Issue 1, Pages 18-21 (January 2015) DOI: 10.1016/j.hrcr.2014.10.003 Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 1 Electrocardiogram, intracardiac electrogram with entrainment, and 3-dimensional (3D) electroanatomic map of patient 1. A: The surface electrocardiogram. B: The electrogram of patient 1 shows atrial tachycardia. Entrainment was performed from the posterior wall of the LA with a postpacing interval of 453 ms. C: The electrogram recorded when the ablator tip in the atrial tachycardia origin site reveals fractionated irregular rhythm as atrial fibrillation with 2:1 and 3:1 conduction. D: The 3D atrial activation map reveals atrial activation starting rhythmically at a small area (0.25 cm2) from where it spread centrifugally (black arrows). The electrogram on the right side reveals a transition from atrial fibrillation in the central area to an organized atrial tachycardia. E: The 3D left atrial voltage map reveals a large low-voltage zone in the posterior wall. The electrogram on the right side reveals a local signal in sinus rhythm after ablation. ABL = tip of ablator; CS = coronary sinus; CSD = distal coronary sinus; CSM = middle coronary sinus; CSP = proximal coronary sinus; LA = left atrium; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein. HeartRhythm Case Reports 2015 1, 18-21DOI: (10.1016/j.hrcr.2014.10.003) Copyright © 2015 Heart Rhythm Society Terms and Conditions

Figure 2 Electrocardiogram, intracardiac electrogram with entrainment, and 3-dimensional (3D) electroanatomic map of patient 2. A: The surface electrocardiogram. B: The electrogram of patient 2 shows atrial tachycardia. Entrainment was performed from the high crista terminalis with a postpacing interval of 438 ms. C: The electrogram recorded when the ablator tip in the atrial tachycardia origin site reveals fractionated irregular rhythm as atrial fibrillation with 2:1 and 3:1 conduction. D: The 3D atrial activation map reveals atrial activation starting rhythmically at a small area (0.25 cm2) from where it spreads centrifugally (black arrows). The electrogram on the right side reveals a transition from atrial fibrillation in the central area to an organized atrial tachycardia. E: The 3D right atrial voltage map reveals a moderate low-voltage zone in the septum. The electrogram on the right side reveals a local signal in sinus rhythm after ablation. ABL = tip of ablator; CS = coronary sinus; CSD = distal coronary sinus; CSM = middle coronary sinus; CSP = proximal coronary sinus; CT = crista terminalis; RA = right atrium HeartRhythm Case Reports 2015 1, 18-21DOI: (10.1016/j.hrcr.2014.10.003) Copyright © 2015 Heart Rhythm Society Terms and Conditions