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Europace Advance Access published online on September 27, 2006
Europace, doi:10.1093/europace/eul101
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© The European Society of Cardiology 2006. All rights reserved
Received December 20, 2005
Accepted May 11, 2006

Article

Ectopic nodal structures in a patient with atrial tachycardia originating from the mitral valve annulus

Taka-aki Matsuyama 1 *, Shin Inoue 2, Kaoru Tanno 3, Mutsuki Makino 1, Genyo Ogawa 4, Tetsuo Sakai 3, Youichi Kobayashi 3, Takashi Katagiri 3, and Hidekazu Ota 1

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

* To whom correspondence should be addressed.
Taka-aki Matsuyama, E-mail: gm00350{at}med.showa-u.ac.jp


  Abstract

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.

Keywords: Atrial tachycardia; Ablation; Histology; Nodal tissue.
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