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Electrophysiological evidence of localized reentry as a trigger and driver of atrial fibrillation at the junction of the superior vena cava and right.

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Presentation on theme: "Electrophysiological evidence of localized reentry as a trigger and driver of atrial fibrillation at the junction of the superior vena cava and right."— Presentation transcript:

1 Electrophysiological evidence of localized reentry as a trigger and driver of atrial fibrillation at the junction of the superior vena cava and right atrium  Atsuhiko Yagishita, MD, Yasuteru Yamauchi, MD, Takamichi Miyamoto, MD, Kenzo Hirao, MD  HeartRhythm Case Reports  Volume 3, Issue 3, Pages (March 2017) DOI: /j.hrcr Copyright © 2017 Heart Rhythm Society Terms and Conditions

2 Figure 1 Intracardiac tracing during the alternation between the 2 atrial tachycardias (ATs). Note the conversion from AT2 to AT1 with the initiation of a temporal gradient of the activation between the distal and proximal bipoles of the ablation catheter (ABL) at the junction of the superior vena cava (SVC) and right atrium (RA). AP = anteroposterior; CS = coronary sinus; LAO = left anterior oblique. HeartRhythm Case Reports 2017 3, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

3 Figure 2 Atrial tachycardia (AT)1 converted into AT2 with the termination of the temporal gradient of the activation, and resumed after the initiation of the temporal gradient of the activation, while fibrillatory activity was seen in the superior vena cava (SVC). That suggested that AT1 was an organized atrial fibrillation driven by the localized reentry at the superior vena cava (SVC) – right atrium (RA) junction. Note the termination of the temporal gradient of the activation with conduction block from the distal (Dist) to proximal (Prox) bipole, suggesting a focal activation was unlikely (hypothesis 1). Abl = ablation catheter; CS = coronary sinus. HeartRhythm Case Reports 2017 3, DOI: ( /j.hrcr ) Copyright © 2017 Heart Rhythm Society Terms and Conditions

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