Focal Atrial Tachycardia Associated with a Macroreentrant Tachycardia: Two Arrhythmias with Different Mechanisms and Similar Morphologies in a Non-surgical Left Atrium with Electrically Silent Areas


This 67-year-old female patient was referred for recurrent episodes of atrial tachycardia. She was repeatedly hospitalised for these episodes in order to undergo pharmacologic or electrical cardioversion. The patient was known to have mitral valve disease with moderate stenosis and regurgitation; left ventricular function was mildly impaired. Since prior oral antiarrhythmic drugs failed to prevent arrhythmia recurrences, an electrophysiologic procedure was planned. On admittance, the patient presented with a tachycardia recurrence. The surface electrocardiogram (Fig. 1) showed atrial tachycardia at a cycle length of 330 ms with a variable atrioventricular conduction and positive P waves in lead I, inferior and left precordial leads, biphasic (negative/ positive) in aVL, biphasic (positive/negative) in V1, and flat in V2, V3.


Left Atrium Coronary Sinus Mitral Annulus Atrial Tachycardia Mitral Valve Disease 
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  1. 1.
    Stevenson IH, Kistler PM, Spence SJ et al. Scar-related right atrial macroreentrant tachycardia in patients without prior atrial surgery: electroanatomic characterization and ablation outcome. Heart Rhythm 2005; 2: 594–601.PubMedCrossRefGoogle Scholar

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© Springer-Verlag Italia 2008

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