A unique iatrogenic organized left atrial tachycardia with a gap conduction in previously ablated lesions

Journal of cardiology
Shiro NakaharaKan Takayanagi

Abstract

This case concerns a 57-year-old woman with an organized left atrial tachycardia (AT) after pulmonary vein (PV) isolation. The left inferior PV (LIPV) exhibited a figure of eight tachycardia around the LIPV ostium with one loop at the anterior aspect and another at the posterior aspect, which corresponded to regular surface P waves. Although a gap ablation of fractionated electrograms changed the LIPV sequence, the atrial potentials were organized with a shortened cycle length accompanied by the same surface P-wave morphology. The elimination of the anterior loop and modification of the posterior loop after the gap ablation might have yielded that specific sequence change of the AT.

References

Nov 15, 2000·Circulation·M HaïssaguerreJ Clémenty
Sep 9, 2004·Circulation·Edward P GerstenfeldFrancis E Marchlinski
Oct 17, 2008·Journal of cardiology·Hirotsugu AtarashiUNKNOWN Flecainide Atrial Fibrillation Investigators

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