Reentrant atrial tachycardia originating from the superior vena cava

• Published in: Journal of interventional cardiac electrophysiology Vol. 8; no. 3; pp. 203 - 208
• Main Authors: OKAMOTO, Kazuhiko, ITO, Hiroyuki, KUMA, Fumiaki, KOIKE, Akihiro, SHIMOIKE, Eimei, UEDA, Norihiro, MARUYAMA, Toru, KAJI, Yoshikazu, FUJINO, Takehiko
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer 01.06.2003; Springer Nature B.V
• Subjects: Biological and medical sciences; Cardiac dysrhythmias; Cardiology. Vascular system; Catheter Ablation; Electrocardiography; Electrophysiologic Techniques, Cardiac - methods; Follow-Up Studies; Heart; Humans; Male; Medical sciences; Middle Aged; Tachycardia, Ectopic Atrial - diagnosis; Tachycardia, Ectopic Atrial - etiology; Tachycardia, Ectopic Atrial - surgery; Treatment Outcome; Vena Cava, Superior - physiopathology; Case study; Human; Arrhythmia; pericardiotomy; Heart disease; Cardiovascular disease; radiofrequency catheter ablation; Atrial tachycardia; reentrant atrial tachycardia; Superior vena cava; Excitability disorder; multielectrode basket catheter
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1023/A:1023969205833

A 52-years old man with a previous pericardiotomy for idiopathic constrictive pericarditis underwent catheter ablation for drug-resistant atrial tachycardia (AT). The mechanism of the AT was considered as reentry because of resetting response and the entrainment phenomenon during AT. We introduced a 64-electrode basket catheter into the superior vena cava (SVC) during AT to obtain precise mapping. A fractionated potential preceding local atrial electrogram was recorded in the SVC. The earliest activation site of the potential was located at the anterior aspect of the SVC, 2 cm above the SVC-right atrium junction determined fluoroscopically. The fractionated potential at this site preceded the onset of the P wave by 115 msec. Radiofrequency catheter ablation at this site eliminated the tachycardia. At 6 months follow-up, the patient is free of AT. Reentrant AT involving the SVC is a candidate of RF ablation. Multielectrode basket catheter is useful for a detailed mapping of the SVC.