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Europace 2002 4(2):207-210; doi:10.1053/eupc.2002.0220
© 2002 by European Society of Cardiology
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CASE REPORTS

Dual-loop intra-atrial re-entry tachycardia in a patient with ischaemic cardiomyopathy

P. Ott

University of Arizona Health Sciences Center, Department of Medicine, Sarver Heart Center U.S.A.

A 65-year-old man with ischaemic cardiomyopathy (three prior coronary artery bypass surgery procedures), underwent catheter ablation for recurrent atrial flutter. Electrophysiological study initially revealed clockwise, tricuspid annulus/inferior vena cava isthmus dependent, atrial flutter. During radiofrequency energy ablation atrial flutter changed into a different atrial tachycardia without change in cycle length or interruption of the tachycardia. The new tachycardia was a right atrial free wall re-entry tachycardia.

Thus the two atrial tachycardias formed a dual-loop (‘figure-of-eight’) re-entry circuit, possibly due to atrial scar tissue from multiple cardiac surgery procedures. Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.

Key Words: Atrial flutter, atrial tachycardia, radiofrequency energy catheter ablation

Correspondence: Peter Ott, MD, Assistant Professor of Medicine, University of Arizona Health Sciences Center, Department of Medicine; Sarver Heart Center, 1501 North Campbell Avenue, Tucson, Arizona 85724, U.S.A. E-mail: ottp{at}u.arizona.edu

[1] Cosio FG, Lopez-Gil M, Goicolea A, Arribas F, Barroso J. Radiofrequency ablation of the inferior vena-cava tricuspid valve isthmus in common atrial flutter. Am J Cardiol 1993; 71: 705–709.[CrossRef][Web of Science][Medline]

[2] Feld GK, Fleck P, Chen PS, et al. Radiofrequency catheter ablation for the treatment of human type I atrial flutter: identification of a critical zone in the re-entry circuit by endocardial mapping techniques. Circulation 1992; 86: 1233–1240.[Abstract/Free Full Text]

[3] Lesh MD, Van Hare GF, Laurence ME, et al. Radiofrequency ablation of atrial arrhythmias. Results and mechanisms. Circulation 1994; 89: 1074–1089.[Abstract/Free Full Text]

[4] Nakagawa H, Shah N, Matsudaira K, et al. Characterization of reentrant circuit in macro-reentrant atrial tachycardia after surgical repair of congenital heart disease. Isolated channels between scars allow ‘focal’ ablation. Circulation 2001; 103: 699–709.[Abstract/Free Full Text]

[5] Shah D, Jaïs P, Takahashi A, et al. Dual-loop intra-atrial reentry in humans. Circulation 2000; 101: 631–639.[Abstract/Free Full Text]


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This Article
Right arrow Abstract Freely available
Right arrow FREE Full Text (PDF) Freely available
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Right arrow Articles by Ott, P.
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Right arrow Articles by Ott, P.
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