Login Register Cart 0
Generic placeholder image

Current Cardiology Reviews

Editor-in-Chief

ISSN (Print): 1573-403X
ISSN (Online): 1875-6557

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe

Atrial Tachycardias Arising from the Atrial Appendages and Aortic Sinus of Valsalva

Author(s): Colleen M. Taylor, Himabindu Samardhi and Haris M. Haqqani

Volume 11, Issue 2, 2015

Page: [118 - 126] Pages: 9

DOI: 10.2174/1573403X10666141013121631

Price: $65

conference banner
Abstract

Focal atrial tachycardias arising from the atrial appendages and the aortic sinuses of Valsalva are less frequently encountered in clinical practice. This review article describes the clinical presentation, surface P wave morphology, electrophysiologic characteristics and treatment of these arrhythmias. Catheter ablation of these focal tachycardias has a high success rate. It is however important to be aware of specific anatomic considerations in these locations for optimal treatment outcomes with low complication rates.

Keywords: Ablation, aortic sinus of Valsalva, atrial appendage, atrial tachycardia, non-coronary cusp.

Graphical Abstract

[1]
Kalman JM, Olgin JE, Karch MR, Hamdan M, Lee RJ, Lesh MD. “Cristal tachycardias”: Origin of right atrial tachycardias from the crista terminalis identified by intracardiac echocardiography. J Am Coll Cardiol 1998; 31(2): 451-9.
[2]
Morton JB, Sanders P, Das A, Vohra JK, Sparks PB, Kalman JM. Focal atrial tachycardia arising from the tricuspid annulus: Electrophysiologic and electrocardiographic characteristics. J Cardiovasc Electr 2001; 12(6): 653-9.
[3]
Kistler PM, Fynn SP, Haqqani H, et al. Focal atrial tachycardia from the ostium of the coronary sinus: Electrocardiographic and electrophysiological characterization and radiofrequency ablation. J Am Coll Cardiol 2005; 45(9): 1488-93.
[4]
Kistler PM, Sanders P, Fynn SP, et al. Electrophysiological and electrocardiographic characteristics of focal atrial tachycardia originating from the pulmonary veins: Acute and long-term outcomes of radiofrequency ablation. Circulation 2003; 108(16): 1968-75.
[5]
Kistler PM, Sanders P, Hussin A, et al. Focal atrial tachycardia arising from the mitral annulus: Electrocardiographic and electrophysiologic characterization. J Am Coll Cardiol 2003; 41(12): 2212-9.
[6]
Iwai S, Badhwar N, Markowitz SM, et al. Electrophysiologic properties of para-hisian atrial tachycardia. Heart Rhythm 2011; 8(8): 1245-53.
[7]
Chen CC, Tai CT, Chiang CE, et al. Atrial tachycardias originating from the atrial septum: Electrophysiologic characteristics and radiofrequency ablation. J Cardiovasc Electr 2000; 11(7): 744-9.
[8]
Marrouche NF. SippensGroenewegen A, Yang Y, Dibs S, Scheinman MM. Clinical and electrophysiologic characteristics of left septal atrial tachycardia. J Am Coll Cardiol 2002; 40(6): 1133-9.
[9]
Wong MC, Kalman JM, Ling LH, et al. Left septal atrial tachycardias: Electrocardiographic and electrophysiologic characterization of a paraseptal focus. J Cardiovasc Electr 2013; 24(4): 413-8.
[10]
Tang CW, Scheinman MM, Van Hare GF, et al. Use of p wave configuration during atrial tachycardia to predict site of origin. J Am Coll Cardiol 1995; 26(5): 1315-24.
[11]
Roberts-Thomson KC, Kistler PM, Haqqani HM, et al. Focal atrial tachycardias arising from the right atrial appendage: Electrocardiographic and electrophysiologic characteristics and radiofrequency ablation. J Cardiovasc Electr 2007; 18(4): 367-72.
[12]
Wang YL, Li XB, Quan X, et al. Focal atrial tachycardia originating from the left atrial appendage: Electrocardiographic and electrophysiologic characterization and long-term outcomes of radiofrequency ablation. J Cardiovasc Electr 2007; 18(5): 459-64.
[13]
Yamada T, Murakami Y, Yoshida Y, et al. Electrophysiologic and electrocardiographic characteristics and radiofrequency catheter ablation of focal atrial tachycardia originating from the left atrial appendage. Heart Rhythm 2007; 4(10): 1284-91.
[14]
Freixa X, Berruezo A, Mont L, et al. Characterization of focal right atrial appendage tachycardia. Europace 2008; 10(1): 105-9.
[15]
Yang Q, Ma J, Zhang S, Hu JQ, Liao ZL. Focal atrial tachycardia originating from the distal portion of the left atrial appendage: Characteristics and long-term outcomes of radiofrequency ablation. Europace 2012; 14(2): 254-60.
[16]
Liu X, Dong J, Ho SY, et al. Atrial tachycardia arising adjacent to noncoronary aortic sinus: Distinctive atrial activation patterns and anatomic insights. J Am Coll Cardiol 2010; 56(10): 796-804.
[17]
Das S, Neuzil P, Albert CM, et al. Catheter ablation of peri-av nodal atrial tachycardia from the noncoronary cusp of the aortic valve. J Cardiovasc Electr 2008; 19(3): 231-7.
[18]
Ouyang F, Ma J, Ho SY, et al. Focal atrial tachycardia originating from the non-coronary aortic sinus: Electrophysiological characteristics and catheter ablation. J Am Coll Cardiol 2006; 48(1): 122-31.
[19]
Rillig A, Meyerfeldt U, Birkemeyer R, et al. Catheter ablation within the sinus of valsalva--a safe and effective approach for treatment of atrial and ventricular tachycardias. Heart Rhythm 2008; 5(9): 1265-72.
[20]
Medi C, Kalman JM, Haqqani H, et al. Tachycardia-mediated cardiomyopathy secondary to focal atrial tachycardia: Long-term outcome after catheter ablation. J Am Coll Cardiol 2009; 53(19): 1791-7.
[21]
Nagai T, Higaki J, Okayama H. Cardiovascular flashlight. Atrial tachycardia in congenital left atrial appendage aneurysm: Three-dimensional computed tomography imaging with electro-anatomical mapping. Eur Heart J 2010; 31(13): 1590.
[22]
Chen SA, Chiang CE, Yang CJ, et al. Sustained atrial tachycardia in adult patients. Electrophysiological characteristics, pharmacological response, possible mechanisms, and effects of radiofrequency ablation. Circulation 1994; 90(3): 1262-78.
[23]
Iwa T, Ichihashi T, Hashizume Y, Ishida K, Okada R. Successful surgical treatment of left atrial tachycardia. Am Heart J 1985; 109(1): 160-2.
[24]
Roberts-Thomson KC, Kistler PM, Kalman JM. Focal atrial tachycardia ii: Management. Pacing Clin Electrophysiol 2006; 29(7): 769-78.
[25]
Kistler PM, Roberts-Thomson KC, Haqqani HM, et al. P-wave morphology in focal atrial tachycardia: Development of an algorithm to predict the anatomic site of origin. J Am Coll Cardiol 2006; 48(5): 1010-7.
[26]
Pandozi C, Galeazzi M, Lavalle C, Ficili S, Russo M, Santini M. Navx-guided cryoablation of atrial tachycardia inside the left atrial appendage. Indian Pacing Electrophysiol J 2011; 10(12): 556-61.
[27]
Raczka F, Granier M, Mathevet L, Davy JM. Radiofrequency ablation of a left appendage focal tachycardia using intracardiac ultrasound image integration to guide catheter: Minimizing the risk of left appendage perforation. Europace 2009; 11(9): 1253-4.
[28]
Phillips KP, Natale A, Sterba R, et al. Percutaneous pericardial instrumentation for catheter ablation of focal atrial tachycardias arising from the left atrial appendage. J Cardiovasc Electr 2008; 19(4): 430-3.
[29]
Yamada T, McElderry HT, Allison JS, Kay GN. Focal atrial tachycardia originating from the epicardial left atrial appendage. Heart Rhythm 2008; 5(5): 766-7.
[30]
Chun KJ, Ouyang F, Schmidt B, Kuck KH. Focal atrial tachycardia originating from the right atrial appendage: First successful cryoballoon isolation. J Cardiovasc Electr 2009; 20(3): 338-41.
[31]
McGarvey JR, Schwartzman D, Ota T, Zenati MA. Minimally invasive epicardial left atrial ablation and appendectomy for refractory atrial tachycardia. Ann Thorac Surg 2008; 86(4): 1375-7.
[32]
Benussi S, Mazzone P, Maccabelli G, et al. Thoracoscopic appendage exclusion with an atriclip device as a solo treatment for focal atrial tachycardia. Circulation 2011; 123(14): 1575-8.
[33]
Wang Z, Liu T, Shehata M, et al. Electrophysiological characteristics of focal atrial tachycardia surrounding the aortic coronary cusps. Circ Arrhythm Electrophysiol 2011; 4(6): 902-8.
[34]
Kistler PM, Kalman JM. Locating focal atrial tachycardias from p-wave morphology. Heart Rhythm 2005; 2(5): 561-4.
[35]
Frey B, Kreiner G, Gwechenberger M, Gossinger HD. Ablation of atrial tachycardia originating from the vicinity of the atrioventricular node: Significance of mapping both sides of the interatrial septum. J Am Coll Cardiol 2001; 38(2): 394-400.
[36]
Jongbloed MR, Schalij MJ, Poelmann RE, et al. Embryonic conduction tissue: A spatial correlation with adult arrhythmogenic areas. J Cardiovasc Electr 2004; 15(3): 349-55.
[37]
Gonzalez MD, Contreras LJ, Jongbloed MR, et al. Left atrial tachycardia originating from the mitral annulus-aorta junction. Circulation 2004; 110(20): 3187-92.
[38]
Raatikainen MJ, Huikuri HV. Successful catheter ablation of focal atrial tachycardia from the non-coronary aortic cusp. Europace 2007; 9(4): 216-9.
[39]
Mlcochova H, Wichterle D, Peichl P, Kautzner J. Catheter ablation of focal atrial tachycardia from the aortic cusp: The role of electroanatomic mapping and intracardiac echocardiography. Pacing Clin Electrophysiol 2013; 36(1): e19-22.
[40]
d’Avila A, Thiagalingam A, Holmvang G, Houghtaling C, Ruskin JN, Reddy VY. What is the most appropriate energy source for aortic cusp ablation? A comparison of standard rf, cooled-tip rf and cryothermal ablation. J Interv Card Electrophysiol 2006; 16(1): 31-8.
[41]
Pons M, Beck L, Leclercq F, Ferriere M, Albat B, Davy JM. Chronic left main coronary artery occlusion: A complication of radiofrequency ablation of idiopathic left ventricular tachycardia. Pacing Clin Electrophysiol 1997; 20(7): 1874-6.

Rights & Permissions Print Cite
Article Metrics
47
2
1
2
Wayfinder Image
© 2024 Bentham Science Publishers | Privacy Policy