Focal Atrial Tachycardias Arising from the Right Atrial Appendage: Electrocardiographic and Electrophysiologic Characteristics and Radiofrequency Ablation

Abstract

The RAA is an uncommon site of origin for focal AT (3.8%). It can be suspected as a potential anatomic site of AT origin from the characteristic P wave and activation timing. Irrigated ablation catheters are often required for successful ablation. Long-term success was achieved with focal ablation in all patients.

Catheter Ablation of Atrial Tachycardia Originating from the Tip of Right Atrial Appendage

“…[1][2][3][4] As seen in our case, right atrial appendage tachycardia has been reported to be more likely in younger male patients, and is more frequently incessant compared with other atrial tachycardias. [1][2][3] The mechanism of right atrial appendage tachycardia is not known. Remnant autorhythmic tissue may be the source of this arrhythmia.…”

“…[1][2][3] However, the structural properties of the atrial appendage, including blind-ended structure, abundant trabeculations, and reduced wall thickness can make the procedure of catheter ablation difficult, especially if the focus is at the tip of atrial the appendage. The wall of the right atrial appendage is very thin and cardiac tamponade caused by perforation could lead to severe complications.…”

“…Atrial tachycardia arising from the right atrial appendage is not common, [1][2][3][4] and some specific clinical and electrophysiologic characteristics have been reported. [1][2][3] The reported incidence of atrial tachycardia arising from right atrial appendage ranges between 0.6% and 8.0% of focal atrial tachycardia.…”

“…[1][2][3] The reported incidence of atrial tachycardia arising from right atrial appendage ranges between 0.6% and 8.0% of focal atrial tachycardia. [1][2][3][4] This atrial tachycardia can be eliminated with a high success rate and low recurrence rate by catheter ablation.…”

“…[1][2][3][4] This atrial tachycardia can be eliminated with a high success rate and low recurrence rate by catheter ablation. [1][2][3] However, the structural properties of the atrial appendage, including blindended structure, abundant trabeculations, and reduced wall thickness can make the procedure of catheter ablation difficult and may cause perforation, especially if the focus is at the tip of the atrial appendage.…”