Ablation of atrial tachycardia originating from the vicinity of the atrioventricular node: significance of mapping both sides of the interatrial septum
Bernhard Frey, MDa,
Gerhard Kreiner, MDa,
Marianne Gwechenberger, MDa and
Heinz D. Gössinger, MDa
a Department of Cardiology, University of Vienna, Vienna, Austria
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Figure 1 (A) Tracings showing atrial activation sequence during ventricular stimulation (left side) and during atrial tachycardia (right side). Tachycardia originated from the right side of the interatrial septum. (B) Tracings showing atrial activation sequence during ventricular stimulation (left side) and during atrial tachycardia (right side). Tachycardia originated from the left side of the interatrial septum. HB = His bundle region; d = distal; m = middle; p = proximal; RAA = right atrial appendage; RV = right ventricle; TA = inferoseptal aspect of the tricuspid annulus.
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Figure 2 Twelve-lead ECG showing P-wave morphology during atrial tachycardia. (A) Tachycardia originating from the right side of the interatrial septum. (B) Tachycardia originating from the left side of the interatrial septum.
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Figure 3 Tracings and radiographs in the right anterior oblique (RAO) and left anterior oblique (LAO) projections of successful ablation sites. (A) Successful ablation site of an atrial tachycardia originating from the right side of the interatrial septum. A distinct His potential was recorded at the successful ablation site. (B) Successful ablation site of an atrial tachycardia originating from the left side of the interatrial septum. The ablation catheter was advanced from the right femoral vein via a trans-septal sheath into the left atrium. The ablation catheter is marked with an arrow. Abbreviations as in Figure 1.
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