Clinical and electrophysiological features of respiratory cycle–dependent atrial tachycardia: An analysis of three cases

Figures

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  Figure 1. Representative electrocardiograms of respiratory cycle–dependent atrial tachycardia (RCAT). A 12-lead electrocardiogram shows incessant atrial short runs linked with respiration induced after sedation. CVP = central venous pressure.

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  Figure 2. Three-dimensional electroanatomic mappings and local intracardiac electrocardiograms of the cases. A: Three-dimensional electroanatomic mapping obtained in the anterior-posterior view showed the earliest activation sites of catheter ablation in case 1 (left) and case 2 (center). In case 3 (right), the earliest activation site was located in the low lateral right atrium (RA). In all 3 cases, radiofrequency ablation of the sites eliminated respiratory cycle–dependent atrial tachycardia (RCAT). IVC = inferior vena cava; LA = left atrium; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein; SVC = superior vena cava. B: Electrocardiogram shows that fragmented potential was detected at the earliest activation site (left); RCAT was eliminated during radiofrequency ablation of the site (right). ABL = ablation catheter; CS = coronary sinus; HIS = His bundle.

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  Figure 3. Relationship between tachycardia onset and respiration. Electrocardiograms of tachycardia initiation and central venous pressure (CVP) in 2 cases, illustrating preceding sinus beats followed by respiratory cycle–dependent atrial tachycardia (RCAT). In case 1, the initiation of RCAT (dotted line) was followed by depression of CVP (arrow); contrarily, in case 2, the initiation of RCAT occurred prior to depression of CVP.