Clinical and electrophysiological features of respiratory cycle–dependent atrial tachycardia: An analysis of three cases Osamu Inaba, MD, Junichi Nitta,

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Presentation transcript:

Clinical and electrophysiological features of respiratory cycle–dependent atrial tachycardia: An analysis of three cases Osamu Inaba, MD, Junichi Nitta, MD, Naoyuki Miwa, MD, Junji Yamaguchi, MD, Yasutoshi Nagata, MD, Kenzo Hirao, MD HeartRhythm Case Reports Volume 4, Issue 1, Pages 18-21 (January 2018) DOI: 10.1016/j.hrcr.2017.10.013 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Representative electrocardiograms of respiratory cycle–dependent atrial tachycardia (RCAT). A 12-lead electrocardiogram shows incessant atrial short runs linked with respiration induced after sedation. CVP = central venous pressure. HeartRhythm Case Reports 2018 4, 18-21DOI: (10.1016/j.hrcr.2017.10.013) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Three-dimensional electroanatomic mappings and local intracardiac electrocardiograms of the cases. A: Three-dimensional electroanatomic mapping obtained in the anterior-posterior view showed the earliest activation sites of catheter ablation in case 1 (left) and case 2 (center). In case 3 (right), the earliest activation site was located in the low lateral right atrium (RA). In all 3 cases, radiofrequency ablation of the sites eliminated respiratory cycle–dependent atrial tachycardia (RCAT). IVC = inferior vena cava; LA = left atrium; LIPV = left inferior pulmonary vein; LSPV = left superior pulmonary vein; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein; SVC = superior vena cava. B: Electrocardiogram shows that fragmented potential was detected at the earliest activation site (left); RCAT was eliminated during radiofrequency ablation of the site (right). ABL = ablation catheter; CS = coronary sinus; HIS = His bundle. HeartRhythm Case Reports 2018 4, 18-21DOI: (10.1016/j.hrcr.2017.10.013) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 Relationship between tachycardia onset and respiration. Electrocardiograms of tachycardia initiation and central venous pressure (CVP) in 2 cases, illustrating preceding sinus beats followed by respiratory cycle–dependent atrial tachycardia (RCAT). In case 1, the initiation of RCAT (dotted line) was followed by depression of CVP (arrow); contrarily, in case 2, the initiation of RCAT occurred prior to depression of CVP. HeartRhythm Case Reports 2018 4, 18-21DOI: (10.1016/j.hrcr.2017.10.013) Copyright © 2017 Heart Rhythm Society Terms and Conditions