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Case Reports
. 2020 Nov 4;7(1):48-51.
doi: 10.1016/j.hrcr.2020.10.012. eCollection 2021 Jan.

Reverse Trendelenburg position modulation to induce atrial tachycardia during supraventricular tachycardia ablation

Asad A Aboud  1 , Gregory F Michaud  1 , Christopher R Ellis  1
Affiliations
Case Reports

Reverse Trendelenburg position modulation to induce atrial tachycardia during supraventricular tachycardia ablation

Asad A Aboud et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Automaticity; Intracardiac echocardiography; Radiofrequency ablation; Reverse Trendelenburg; SVT.

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Figures

Figure 1
Figure 1
A: The patient’s presenting electrocardiogram, which shows salvos of supraventricular tachycardia that appear to be consistent with atrial tachycardia. B: Telemetry during the admission showed very frequent runs of the same atrial tachycardia.
Figure 2
Figure 2
A picture from the ablation procedure that shows the ∼30-degree reverse Trendelenburg position, which readily induced the patient’s supraventricular tachycardia. The ablation procedure was done with intracardiac echocardiography (ICE) guidance and no fluoroscopy, which made achieving this position easier.
Figure 3
Figure 3
A: The final activation map in right anterior oblique (left) and left lateral (middle) projections. The red dots indicate the site of ablation that successfully terminated tachycardia. The light yellow dots in the supraventricular tachycardia correspond to the phrenic nerve location and the darker yellow dots by the tricuspid valve indicate the His signal location. The right side of the panel shows the early local activation at the location of the mapping catheter (turquoise color) as compared to the surface P wave (yellow arrow). B: Intracardiac echocardiography (ICE)–guided ablation, with the left side indicating the section of the right atrium through the ablation site that is represented by the ICE image on the right. ICE was used to check the ablation catheter location and confirm surface contact with tissue throughout the procedure. Abl = ablation; IVC = inferior vena cava; RAA = right atrial appendage; TV = tricuspid valve.
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