This case series demonstrates that repetitive paroxysmal tachycardia can originate from the left atrium, as confirmed by ECG and pressure curve analysis.
Left atrial origin possible in repetitive paroxysmal SVT; case series leaves open prevalence and mapping implications for ablation.
Three patients with repetitive supraventricular paroxysmal tachycardia are described, one of them with an atrial septal defect in addition. All three patients were asymptomatic; two, however, had a striking cardiomegaly (one of these is the patient with atrial septal defect). The electrocardiogram showed supraven- tricular tachycardia of medium frequency as the predominant rhythm, interrupted by phases of normal sinus rhythm of varying duration. The P waves were present during tachycardia and suggested a left atrial pace- maker. This was confirmed by comparison of right and left atrial (or pulmonary arterial wedge, respectively) pressure curves during both normal sinus rhythm and supraventricular tachycardia.
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Bernuth et al. (1973) studied this question.
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