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A Non-clinical Macroreentrant Right Atrial Tachycardia with Two Independent Loops: the Exception to the Rule of a Shared Mid-diastolic Isthmus in Double-loop Reentry

Abstract

This is a 34-year-old male patient with congenital ventricular septal defect and subvalvular aortic stenosis. At the age of 1, he underwent surgical closure of the ventricular septal defect, which involved surgical incision of the right atrium. At the age of 11, the subvalvular aortic stenosis was surgically corrected. Before this intervention, at the age of 8, he underwent right pneumectomy for hemoptisis due to congenital absence of the right pulmonary artery. Six months before the procedure he complained of two episodes of palpitations. These were documented by surface ECG as counter-clockwise typical atrial flutter, requiring DC-shock cardioversion to restore sinus rhythm. Subsequently, he was referred for an electrophysiology procedure while on sinus rhythm and in wash-out from antiarrhythmic drug therapy. Echocardiography showed neither residual shunts nor significant gradient in the left outflow tract; left ventricular function was preserved.

Keywords

Coronary Sinus Superior Vena Outer Loop Atrial Flutter Right Bundle Branch Block 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

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    De Ponti R, Verlato R, Bertaglia E et al. Treatment of macroreentrant atrial tachycardia based on electroanatomic mapping: identification and ablation of the mid-diastolic isthmus. Europace 2007; 9: 449–457.PubMedCrossRefGoogle Scholar
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    El Sherif N, Mehra R, Gough WB et al. Reentrant ventricular arrhythmias in the late myocardial infarction period: interruption of reentrant circuits by cryothermal techniques. Circulation 1983; 8: 644–656.Google Scholar

Copyright information

© Springer-Verlag Italia 2008

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