Development of Lower Loop Reentrant Atrial Tachycardia in a Patient Late after Surgical Operation of Multiple Right-sided Accessory Pathways

Yasushi Oginosawa, MD; Haruhiko Abe, MD; Ritsuko Kohno, MD; Hitoshi Minamiguchi, MD; Masahito Tamura, MD; Masaaki Takeuchi, MD; Yutaka Otsuji, MD

doi:10.1016/S1880-4276(11)80048-7

Journal of Arrhythmia (Jan 2011)

Development of Lower Loop Reentrant Atrial Tachycardia in a Patient Late after Surgical Operation of Multiple Right-sided Accessory Pathways

Yasushi Oginosawa, MD,
Haruhiko Abe, MD,
Ritsuko Kohno, MD,
Hitoshi Minamiguchi, MD,
Masahito Tamura, MD,
Masaaki Takeuchi, MD,
Yutaka Otsuji, MD

Affiliations

Yasushi Oginosawa, MD: The Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
Haruhiko Abe, MD: Department of Heart Rhythm Management, University of Occupational and Environmental Health, Kitakyushu, Japan
Ritsuko Kohno, MD: The Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
Hitoshi Minamiguchi, MD: The Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
Masahito Tamura, MD: The Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
Masaaki Takeuchi, MD: The Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan
Yutaka Otsuji, MD: The Second Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan

DOI: https://doi.org/10.1016/S1880-4276(11)80048-7
Journal volume & issue: Vol. 27, no. 3
pp. 220 – 225

Abstract

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A 50-year-old man developed a symptomatic tachyarrhythmia 22 years after surgical division of multiple right-sided accessory pathways. Electro-anatomical mapping during sinus rhythm revealed an electrically isolated ectopic focus on the right atrial free wall near the tricuspid annulus (TA). Activation map during tachycardia indicated the presence of lower loop reentry (LLR) with collision of the wavefronts in the high right atrium. The isthmus of slow conduction was located between the surgical incision near the posterior TA and the inferior vena cava. LLR was eliminated by radiofrequency linear ablation at the cavotricuspid isthmus.

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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