Noncontact Mapping-Guided Catheter Ablation of Posterosuperior Right Atrial Tachycardia Associated with Sick Sinus Syndrome

Shioto Yasuda, Hirofumi Nakamura, Eiji Karashima, Jin Ueda, Gen Nakaji, Hideki Shimazu, Shin ichi Hiramatsu, Keita Odashiro, Toru Maruyama, Yoshikazu Kaji

Research output: Contribution to journalArticle

Abstract

Focal atrial tachycardia (AT) is sometimes associated with sick sinus syndrome. A 57-year-old female complained of palpitation, fatigue and presyncope. Ambulatory monitoring demonstrated frequent segments of AT and subsequent sinus arrests. P wave morphology of ectopic beats was similar to that of sinus rhythm. After obtaining diagnosis of bradycardia tachycardia syndrome, she underwent electrophysiologic study (EPS) and radiofrequency (RF) catheter ablation to eliminate AT. Conventional EPS could not be performed due to frequent spontaneous ectopic beats. EnSite mapping demonstrated that AT originates from posterosuperior right atrium (RA) and that local electrogram of ectopic focus precedes the onset of P wave in surface ECG by 40 msec. After EnSite-guided RF ablation to the target area, ambulatory monitoring detected no AT or sinus arrest. EPS performed one week after RF ablation showed atropine-induced partial restoration of sinus node dysfunction. Her symptoms were resolved remarkably and permanent pacemaker implantation has not been necessary to date. RF ablation guided by EnSite mapping was useful to eliminate AT arising from limited ectopic focus and this case implies existence of “pacemaker-avoidable” bradycardia tachycardia syndrome.

Original languageEnglish
Pages (from-to)33-37
Number of pages5
Journaljournal of arrhythmia
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 1 2008

Fingerprint

Sick Sinus Syndrome
Catheter Ablation
Tachycardia
Sinus Tachycardia
Ambulatory Monitoring
Bradycardia
Syncope
Heart Atria
Atropine
Fatigue
Electrocardiography

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Noncontact Mapping-Guided Catheter Ablation of Posterosuperior Right Atrial Tachycardia Associated with Sick Sinus Syndrome. / Yasuda, Shioto; Nakamura, Hirofumi; Karashima, Eiji; Ueda, Jin; Nakaji, Gen; Shimazu, Hideki; Hiramatsu, Shin ichi; Odashiro, Keita; Maruyama, Toru; Kaji, Yoshikazu.

In: journal of arrhythmia, Vol. 24, No. 1, 01.01.2008, p. 33-37.

Research output: Contribution to journalArticle

Yasuda, S, Nakamura, H, Karashima, E, Ueda, J, Nakaji, G, Shimazu, H, Hiramatsu, SI, Odashiro, K, Maruyama, T & Kaji, Y 2008, 'Noncontact Mapping-Guided Catheter Ablation of Posterosuperior Right Atrial Tachycardia Associated with Sick Sinus Syndrome', journal of arrhythmia, vol. 24, no. 1, pp. 33-37. https://doi.org/10.4020/jhrs.24.33
Yasuda, Shioto ; Nakamura, Hirofumi ; Karashima, Eiji ; Ueda, Jin ; Nakaji, Gen ; Shimazu, Hideki ; Hiramatsu, Shin ichi ; Odashiro, Keita ; Maruyama, Toru ; Kaji, Yoshikazu. / Noncontact Mapping-Guided Catheter Ablation of Posterosuperior Right Atrial Tachycardia Associated with Sick Sinus Syndrome. In: journal of arrhythmia. 2008 ; Vol. 24, No. 1. pp. 33-37.
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