Journal of Arrhythmia (Jan 2008)

Catheter Ablation of Ectopic Atrial Tachycardia Originating from the Left Atrial Appendage using CARTOMERGE® System

  • Masahiko Goya, MD,
  • Ken-ichi Hiroshima, MD,
  • Hitoshi Yasumoto, MD,
  • Harushi Niu,
  • Yoshimitsu Soga, MD,
  • Kenji Ando, MD,
  • Hideyuki Nosaka, MD,
  • Masakiyo Nobuyoshi, MD

Journal volume & issue
Vol. 24, no. 2
pp. 87 – 90


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A 70-year-old woman was referred because of drug resistant and daily incessant palpitation attack. She had undergone two previous unsuccessful radiofrequency catheter ablations at another hospital. The physical examination, chest X-ray, and echocardiogram were all normal. The 12-lead ECG during tachycardia showed narrow QRS, short PR tachycardia and negative polarity of the P wave in leads I and aVL (Fig. 1A). The ECG monitor showed incessant tachycardia with warming-up phenomenon. Three dimensional electroanatomical map integrated with CT imaging (CARTOMERGE®, Biosense Webster Inc.) clearly revealed the radial activation pattern originating from the basalo-postero-inferior aspect of the left atrial appendage. Radiofrequency energy application at this site eliminated tachycardia permanently.