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Europace Advance Access originally published online on April 21, 2009
Europace 2009 11(6):823-826; doi:10.1093/europace/eup086
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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

SHORT COMMUNICATIONS

Adenosine sensitive focal atrial tachycardia originating from the non-coronary aortic cusp

Reinhold Weber, Konstantinos P. Letsas*, Thomas Arentz and Dietrich Kalusche

Abteilung Rhythmologie, Herz-Zentrum, Südring 15, 79189 Bad Krozingen, Germany

We report on the characteristics and the ablation procedure of a focal atrial tachycardia originating from the non-coronary aortic cusp. The electrophysiological features of the tachycardia included: (i) incessant pattern; (ii) easy induction and termination by atrial stimulation; (iii) earliest right atrial activation at the para-hisian area; and (iv) termination by adenosine. Left-sided mapping revealed the earliest atrial activation during the tachycardia at the non-coronary aortic cusp. Radiofrequency energy application at this site successfully terminated the tachycardia. Mapping of the non-coronary aortic cusp should always be considered when the earliest right atrial activation is recorded at the para-hisian area in order to avoid the risk of atrioventricular block by inappropriate ablation near the His-bundle region.

* Corresponding author. Tel: +4976339290979, Fax: +4976334022429, Email: k.letsas{at}mail.gr

Manuscript submitted 3 December 2008. Accepted after revision 20 March 2009.


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