Key result
Radiofrequency ablation in the non-coronary aortic cusp successfully eliminated adenosine-sensitive focal atrial tachycardia originating near the His-bundle region without AV nodal injury.
Case Report (n=1)
Radiofrequency ablation from the non-coronary aortic cusp can be a safe and effective alternative for treating focal atrial tachycardia originating near the His-bundle region when right atrial ablation risks AV nodal injury.
May support non-coronary cusp ablation for per-Hisian focal AT to avoid AV nodal injury; hypothesis-generating and should not yet change practice.
The case of a patient with narrow QRS tachycardia is herein presented. During an electrophysiological study, this tachycardia was diagnosed as a focal atrial tachycardia with a high sensitivity to adenosine-5′-triphosphate (2 mg), and originating from near the His-bundle region. We could not ablate the earliest activation site in the right atrium because of the simultaneous recording of the His potential. The radiofrequency applications in the right atrium around the earliest activation site failed to terminate the tachycardia. Subsequent attempt of radiofrequency application in the non-coronary aortic cusp, where the earliest atrial activation without His potential was obtained, successfully eliminated the tachycardia without any atrioventricular nodal injury.
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Yamashita et al. (2010) conducted a case report in Adenosine sensitive atrial tachycardia originating from the His-bundle region (n=1). Radiofrequency ablation in the non-coronary aortic cusp was evaluated on Elimination of tachycardia. Radiofrequency ablation in the non-coronary aortic cusp successfully eliminated adenosine-sensitive focal atrial tachycardia originating near the His-bundle region without AV nodal injury.
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