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

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Presentation on theme: "Peter Kabunga, MBChB, MRCP, George J. Klein, MD, FHRS, Raymond W"— Presentation transcript:

1 Preferential conduction during focal atrial tachycardia arising from the noncoronary cusp 
Peter Kabunga, MBChB, MRCP, George J. Klein, MD, FHRS, Raymond W. Sy, MBBS, PhD  HeartRhythm Case Reports  Volume 2, Issue 5, Pages (September 2016) DOI: /j.hrcr Copyright © 2016 Heart Rhythm Society Terms and Conditions

2 Figure 1 A: Alternating P-wave morphology during tachycardia, demonstrated in lead V1. B, C: Premature ventricular tachycardia delivered from the right ventricle during tachycardia demonstrates 2 distinct P-wave morphologies with corresponding activation maps (left-lateral projection). D: Map 1,2 refers to local electrogram at superior septum (during negative-positive morphology, denoted by *; and during positive-negative P wave, denoted by #). See text for details. HeartRhythm Case Reports 2016 2, DOI: ( /j.hrcr ) Copyright © 2016 Heart Rhythm Society Terms and Conditions

3 Figure 2 A,B: Fluoroscopic image (right anterior oblique view); C,D: fluoroscopic image (left anterior oblique view): Ablation catheter (Map) is at the successful site in the noncoronary aortic cusp. TA = 20-pole catheter in RA; His = catheter at the His area; CS = 10-pole coronary sinus catheter. E: Ablation catheter (Map1,2) at the successful ablation site in the noncoronary aortic cusp. Map “A” precedes His “A” (His 3,4) by 15 ms and onset of surface P wave by ~30 ms during both positive-negative and negative-positive morphologies in V1. HeartRhythm Case Reports 2016 2, DOI: ( /j.hrcr ) Copyright © 2016 Heart Rhythm Society Terms and Conditions

4 Figure 3 Tachycardia terminates after 6 seconds of radiofrequency application in the noncoronary aortic cusp. HeartRhythm Case Reports 2016 2, DOI: ( /j.hrcr ) Copyright © 2016 Heart Rhythm Society Terms and Conditions

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