Europace Advance Access originally published online on September 27, 2006
Europace 2006 8(11):977-979; doi:10.1093/europace/eul101
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ELECTROPHYSIOLOGY
Ectopic nodal structures in a patient with atrial tachycardia originating from the mitral valve annulus
1 Second Department of Pathology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan; 2 Department of Internal Medicine, Showa University Dental Hospital, Tokyo, Japan; 3 Third Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan; 4 Department of Internal Medicine, Showa University Toyosu Hospital, Tokyo, Japan
We report a case, which we believe to be rare, of adenosine-sensitive atrial tachycardia (AT) originating from the mitral valve annulus. The patient, a 73-year-old woman, died of unrelated cause 4 years after radiofrequency (RF) ablation therapy. Histologically, fibrous replacement of atrial musculature by mature collagenous tissue produced by the RF current was observed at the left inferior atrioventricular junction. In serial sections that included the coronary sinus, two distinct nodal structures containing small, pale myocytes within the fibrous tissue matrix were identified around the region of the ablation lesion. Our case appears to be a unique representation of tissue that was associated with the occurrence and maintenance of AT.
Key Words: Atrial tachycardia, Ablation, Histology, Nodal tissue
* Corresponding author. Tel: +81 3 3784 8122; fax: +81 3 3784 2959. E-mail address: gm00350{at}med.showa-u.ac.jp