Histological examination of the right atrial appendage after failed catheter ablation for focal atrial tachycardia complicated by cardiogenic shock in a post-partum patient

Akira Mizukami, MD; Makoto Suzuki, MD; Rena Nakamura, MD; Shunsuke Kuroda, MD; Maki Ono, MD; Yuya Matsue, MD; Ryota Iwatsuka, MD; Taishi Yonetsu, MD; Akihiko Matsumura, MD; Yuji Hashimoto, MD

doi:10.1016/j.joa.2016.01.001

Journal of Arrhythmia (Jun 2016)

Histological examination of the right atrial appendage after failed catheter ablation for focal atrial tachycardia complicated by cardiogenic shock in a post-partum patient

Akira Mizukami, MD,
Makoto Suzuki, MD,
Rena Nakamura, MD,
Shunsuke Kuroda, MD,
Maki Ono, MD,
Yuya Matsue, MD,
Ryota Iwatsuka, MD,
Taishi Yonetsu, MD,
Akihiko Matsumura, MD,
Yuji Hashimoto, MD

Affiliations

Akira Mizukami, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Makoto Suzuki, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Rena Nakamura, MD: Department of Cardiology, Yokohama Minami Kyousai Hospital, 1-21-1 Mutsuurahigashi, Kanazawa-ku, Yokohama, Kanagawa 236-0037, Japan
Shunsuke Kuroda, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Maki Ono, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Yuya Matsue, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Ryota Iwatsuka, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Taishi Yonetsu, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Akihiko Matsumura, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan
Yuji Hashimoto, MD: Department of Cardiology, Kameda Medical Center, 929 Higashi-cho, Kamogawa, Chiba 296-8602, Japan

DOI: https://doi.org/10.1016/j.joa.2016.01.001
Journal volume & issue: Vol. 32, no. 3
pp. 227 – 229

Abstract

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A 26-year-old woman in her first pregnancy presented with persistent atrial tachycardia (AT). AT was resistant to medications, cardioversions, and the first attempt of catheter ablation. Two months after delivery she developed severe systolic dysfunction and circulatory collapse. Emergent catheter ablation was performed with the support of percutaneous cardiopulmonary bypass and intraaortic balloon pump. The AT originated in the apex of the right atrial appendage (RAA). Repeated attempts at ablation were unsuccessful, prompting surgical RAA resection, which terminated the tachycardia and improved the cardiac function. Histological examination of resected RAA provided insights into mechanism of resistance to catheter ablation.

Published in Journal of Arrhythmia

ISSN: 1880-4276 (Print); 1883-2148 (Online)
Publisher: Wiley
Country of publisher: Australia
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://onlinelibrary.wiley.com/journal/18832148

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