Small Reentrant Atrial Tachycardia Adjacent to Left Aortic Sinus of Valsalva

Maeda, Shingo; Yamauchi, Yasuteru; Tao, Susumu; Okada, Hiroyuki; Obayashi, Tohru; Hirao, Kazuyuki

doi:10.1253/circj.cj-13-0437

Cited by 5 publications

(6 citation statements)

References 7 publications

(3 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In patients with larger contact area the resulting fibrosis would be more extensive and thus result in multiple AT/AF. 9,10 In conclusion, we report a rare case of incessant AT arising from the arrhythmogenic effect of LA anterior wall compression by the aortic root.…”

Section: Discussionmentioning

confidence: 75%

Unusual cause of incessant atrial tachycardia

Ekanem

Wish

Strickberger

et al. 2020

HeartRhythm Case Reports

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 75%

Unusual cause of incessant atrial tachycardia

Ekanem

Wish

Strickberger

et al. 2020

HeartRhythm Case Reports

View full text Add to dashboard Cite

“…However, a spontaneous scar can arise in the LA and can act as an arrhythmia substrate [11]. The most common region for a spontaneous scar to develop is the aorta-LA contiguous area; in this region, rigid contact between the aorta and LA exits, which can promote fibrosis and lead to scar formation [12, 13]. Hori Y. et al demonstrated 68% of the LA very low voltage area (<0.2 mV) overlapped with areas of the LA that contact external anatomical structures, such as the aorta and vertebra, suggesting that contact with external anatomical structures may influence scar formation [13].…”

Section: Discussionmentioning

confidence: 99%

“…In cases of spontaneous scar, the aorta-LA contiguous scar area has been reported to be involved in the reentry circuit of localized reentrant AT [12]. However, other mechanisms, such as automaticity and triggered activity, may also be involved in the arrhythmogenesis of ATs due to scar [18].…”

Section: Discussionmentioning

confidence: 99%

Multiple focal and macroreentrant left atrial tachycardias originating from a spontaneous scar at the contiguous aorta-left atrium area in a patient with hypertrophic cardiomyopathy: a case report

Yazaki

Mori

Watanabe

et al. 2017

BMC Cardiovasc Disord

View full text Add to dashboard Cite

BackgroundSpontaneous scar-related left atrial tachycardia (AT) is a rare arrhythmia. We describe a patient with hypertrophic cardiomyopathy (HCM) who developed multiple, both focal and macroreentrant left ATs associated with a spontaneous scar located at the aorta-left atrium (LA) contiguous area.Case presentationA 65-year-old man with HCM complained of palpitations. Twelve-lead electrocardiogram showed narrow QRS tachycardia with 2:1 atrioventricular conduction. Two sessions of radiofrequency ablation (RFA) were required to eliminate all left ATs. In the first session, 3-dimensional electroanatomical mapping fused with the image constructed by multi-detector computed tomography showed a clockwise macroreentrant AT (AT1) associated with a low-voltage or dense scar area located along the aorta-LA contiguous area. AT1 was eliminated by RFA to the narrow isthmus with slow conduction velocity within the scar. Additional ATs (AT2-AT4) occurred 1 month after the first ablation. In the second session, AT2 and AT3 were identified as focal ATs with centrifugal propagation and few accompanying fragmentations, and AT4 as a macroreentrant AT with features similar to AT1. AT2 and AT3 were successfully eliminated by performing RFA to the earliest activation site, and AT4 was terminated by performing RFA to the narrow isthmus with slow conduction velocity. No ATs have recurred for 11 months after these RFAs. Interestingly, the substrate for all left ATs was associated with the aorta-LA contiguous area.ConclusionTo our knowledge, this is the first case of multiple, both focal and macroreentrant left ATs associated with a contiguous aorta-LA spontaneous scar area in a patient with HCM.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-016-0448-3) contains supplementary material, which is available to authorized users.

show abstract

“…4 In addition, the contiguous aorta-LA area around the mitral annulus is reported to be responsible for the low-voltage area in cases of AT originating from the LA. 5, 6 Ejima et al reported the case of a 69-year-old man with idiopathic dilated cardiomyopathy presenting with localized reentrant AT in the context of atrial fibrillation ablation, 7 and Maeda et al reported the case of a 70-year-old man with small reentrant AT, 8 and in these 2 cases the AT originated from the contiguous aorta-LA area. In the present case, the localized reentrant AT originated from the contiguous right PA-LA area, and compression of the dilated LA by the right PA may have contributed to the fibrosis of the LA anterior wall.…”

Section: Images In Cardiovascular Medicine Localized Reentrant At Witmentioning

confidence: 99%