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Case Reports
. 2024 Mar 11;10(6):381-386.
doi: 10.1016/j.hrcr.2024.03.001. eCollection 2024 Jun.

Successful radiofrequency catheter ablation of focal atrial tachycardia originating from right atrial appendage anomaly

Reshma Amin  1 , Brian Campbell  1 , Michael Green  1 , Ronak Rajani  1   2 , Matthew Wright  1   2 , John Whitaker  1   2
Affiliations
Case Reports

Successful radiofrequency catheter ablation of focal atrial tachycardia originating from right atrial appendage anomaly

Reshma Amin et al. HeartRhythm Case Rep. .
No abstract available

Keywords: Atrial tachycardia; Intracardiac echocardiogram; Radiofrequency ablation; Right atrial appendage anomaly; Tachycardia-induced cardiomyopathy.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
A: Twelve-lead electrocardiogram demonstrating AT with atrial cycle length of approximately 400 ms and negative p waves in V1. B: Transesophageal echocardiogram mid esophageal 0-degree view demonstrating abnormal cavity anterior to the RA free wall (white arrow). C, D: LVOT VTI on transthoracic echocardiogram increase, from prior to AT ablation with ongoing arrhythmia, to 4 months following AT ablation in sinus rhythm. AT = atrial tachycardia; RA = right atrium; LA = left atrium; RV = right ventricle; LV = left ventricle; LVOT VTI = left ventricular outflow tract velocity time integral.
Figure 2
Figure 2
A: Electroanatomical mapping showing focal activation originating from aneurysmal pouch in the RA lateral wall with blue ablation lesion that resulted in final termination of tachycardia (white arrow). B: Intracardiac echocardiogram image of RA insertion of accessory lobe of appendage. C: Electrogram on ablation catheter at site of termination; red arrow indicates bipolar recording with activation early in p wave, green arrow indicates unipolar recording with QS morphology. D: Surface electrocardiogram V1 lead, CS catheter, and ablation demonstrating ablation onset and rapid cessation of tachycardia. E: Power and impedance during ablation within RA pouch. CS = coronary sinus; RA= right atrium; SVC = superior vena cava.
Figure 3
Figure 3
A: Axial slice of cardiac computed tomography angiography showing small contrast-filled channel arising from a superior aspect of the SVC. B: Anomalous RAA arising from SVC just superior to the junction of the SVC to the RA. C: Connection of RAA to RA; note in panels B and C the absence of the conventionally sited RAA. D, E: Three-dimensional cinematic volume-rendered images showing oblique views of the right heart and location of anomalous RAA. F: Histology of LV biopsy demonstrating occasional hypertrophic myocytes with no inflammation or fibrosis. Ao = aorta; LA = left atrium; LV = left ventricle; RA = right atrium; RAA = right atrial appendage; RV = right ventricle; RVOT = right ventricular outflow tract; SVC = superior vena cava.
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