High resolution map of aortic root tachycardia

A 63-year-old woman without structural heart disease was referred with frequent, sustained episodes of atrial tachycardia. The episodes had terminated spontaneously before vagal manoeuvres or acute pharmacological intervention could be tried. Tachycardia with a cycle length 390 –420 ms was induced. High-density electroanatomic mapping using the Carto mapping system and a pentaray mapping catheter revealed earliest right atrial activation close to the His bundle. The earliest left atrial activation was in an adjacent position at similar timing, but mapping in the aortic root revealed earlier activation than obtained endocardially in either atrium (Panel A). In the non-coronary sinus of Valsalva, low-amplitude atrial electrograms preceded any other electrogram by 20  ms (Panel B). Radiofrequency delivery at this site terminated the tachycardia, resulting in non-inducibility and clinical resolution.
Source: Europace - Category: Cardiology Source Type: research