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Europace Advance Access originally published online on February 20, 2009
Europace 2009 11(4):521-522; doi:10.1093/europace/eup046
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

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Focal atrial tachycardia refractory to radiofrequency catheter ablation originating from right atrial appendage

Hiroshi Furushima*, Masaomi Chinushi, Yukio Hosaka and Yoshifusa Aizawa

The First Department of Internal Medicine, Niigata University School of Medicine, 1-754 Asahi-machi-dori, Niigata 951-8510, Japan

A 44-year-old female presented with incessant, drug-refractory atrial tachycardia (AT). An electrophysiological study suggested focal abnormal automaticity, and localized the AT origin to the apex of the right atrial appendage (RAA). Repeated radiofrequency catheter ablation to the site of the earliest endocardial activation during AT failed. At surgery, right atrial appendectomy terminated the AT. On macroscopic findings, the cavity of the RAA became a dead-end before the apex. In patients with drug and radiofrequency catheter ablation, refractory focal AT arising from the RAA, especially the apex of the RAA, in our opinion surgical treatment could be considered in the lack of efficacy of ablation.

* Corresponding author. Tel: +81-25-227-2185, Fax: +81-25-227-0774, Email: chimiri{at}med.niigata-u.ac-jp

Manuscript submitted 29 October 2008. Accepted after revision 31 January 2009.


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