Transvenous catheter ablation of a right atrial automatic ectopic tachycardia

A 10 year old patient with right atrial automatic ectopic tachycardia underwent successful transvenous catheter ablation after endocardial mapping. Tachycardia had been present for 7 years before ablation and associated with development of dilated cardiomyopathy. A single 50 J discharge at the point of earliest atrial activation was followed by the establishment of sinus rhythm that remains at 10 months' follow-up. This case represents the first reported successful catheter ablation of an atrial automatic ectopic tachycardia. Specific anatomic factors favoring successful ablation and improvement in technique are discussed.