Atrial Tachycardia Originating from the Cavo-Tricuspid Isthmus May Exhibit Narrow P Waves |
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Authors: | Takumi Yamada H. Thomas McElderry James D Allred Harish Doppalapudi G. Neal Kay |
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Affiliation: | Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA |
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Abstract: | An 83-year-old man underwent electrophysiological testing for focal atrial tachycardia (AT) exhibiting narrow P waves with negative deflections in the inferior leads. Catheter ablation at the cavo-tricuspid isthmus (CTI) successfully eliminated the AT. The propagation map during AT and pacing study from the successful ablation site demonstrated that the atrial activation throughout the CTI did not produce significant P wave deflections. Consequently, during AT, the left atrial activation time determined the P wave duration. This case demonstrates that AT originating from the CTI may exhibit narrow P waves which can be misinterpreted as AT originating from the inter-atrial septum. |
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Keywords: | focal atrial tachycardia cavo-tricuspid isthmus P wave radiofrequency catheter ablation |
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