Journal of Arrhythmia (Jan 2010)

A Case of Adenosine Sensitive Atrial Tachycardia Originating from the His-Bundle Region Successfully Ablated from the Non-coronary Aortic Cusp

  • Seigo Yamashita, MD,
  • Teiichi Yamane, MD,
  • Seiichiro Matsuo, MD,
  • Keiichi Ito, MD,
  • Ryohsuke Narui, MD,
  • Mika Hioki, MD,
  • Tokiko Nakane, MD,
  • Michifumi Tokuda, MD,
  • Yasuko Aramaki, MD,
  • Keiichi Inada, MD,
  • Kenri Shibayama, MD,
  • Satoru Miyanaga, MD,
  • Hiroshi Yoshida, MD,
  • Taro Date, MD,
  • Hidekazu Miyazaki, MD,
  • Kunihiko Abe, MD,
  • Ken-ichi Sugimoto, MD,
  • Michihiro Yoshimura, MD

DOI
https://doi.org/10.1016/S1880-4276(10)80035-3
Journal volume & issue
Vol. 26, no. 1
pp. 44 – 49

Abstract

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The case of a patient with narrow QRS tachycardia is herein presented. During an electrophysiological study, this tachycardia was diagnosed as a focal atrial tachycardia with a high sensitivity to adenosine-5′-triphosphate (2 mg), and originating from near the His-bundle region. We could not ablate the earliest activation site in the right atrium because of the simultaneous recording of the His potential. The radiofrequency applications in the right atrium around the earliest activation site failed to terminate the tachycardia. Subsequent attempt of radiofrequency application in the non-coronary aortic cusp, where the earliest atrial activation without His potential was obtained, successfully eliminated the tachycardia without any atrioventricular nodal injury.

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