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An unusual case of permanent junctional reciprocating tachycardia: Successful ablation at the mitral annulus-aorta junction

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Abstract

A 25-year-old woman with drug-refractory permanent junctional reciprocating tachycardia (PJRT) and a previous failed ablation, was referred to our institution. Electrophysiological study confirmed the diagnosis of orthodromic atrioventricular reentry tachycardia using a slowly conducting accessory pathway. This accessory pathway was successfully ablated by conventional radiofrequency at the left anteroseptal region using a transseptal approach. Catheter ablation of this accessory pathway (Coumel type) at the mitral annulus-aorta junction offers insights on a rare anatomical location of PJRT.

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References

  1. 1.

    Critelli, G. (2001). Permanent junctional reciprocating tachycardia: An Update. Cardiac Electrophysiology Review, 5, 307–314.

  2. 2.

    Meiltz, A., Weber, R., Halimi, F., et al. (2006). Permanent form of junctional reciprocating tachycardia in adults: Peculiar features and results of radiofrequency catheter ablation. Europace, 8, 21–28.

  3. 3.

    Ticho, B. S., Saul, J. P., Hulse, J. E., De, W., Lulu, J., & Walsh, E. P. (1992). Variable location of accessory pathways associated with the permanent form of junctional reciprocating tachycardia. American Journal of Cardiology, 70, 1559–1564.

  4. 4.

    Hirao, K., Otomo, K., Wang, X., Beckman, K. J., McClelland, J. H., Widman, L., et al. (1996). Para-Hisian pacing. A new method for differentiating retrograde conduction over an accessory AV pathway from conduction over the AV node. Circulation, 194(5), 1027–1035.

  5. 5.

    Reddy, V. Y., Jongnarangsin, K., Albert, C. M., et al. (2003). Para-Hisian entrainment: A novel pacing maneuver to differentiate orthodromic atrioventricular reentrant tachycardia from atrioventricular nodal reentrant tachycardia. Journal of Cardiovascular Electrophysiology, 14, 1321–1328.

  6. 6.

    Ouyang, F., Fotuhi, P., Ho, S. Y., Hebe, J., Volkmer, M., Goya, M., et al. (2002). Repetitive monomorphic ventricular tachycardia originating from the aortic sinus cusp: Electrocardiographic characterization for guiding catheter ablation. Journal of the American College of Cardiology, 39(3), 500–508.

  7. 7.

    Anderson, R. H., & Ho, S. Y. (1997). Anatomy of the atrioventricular junctions with regard to ventricular preexcitation. Pacing and Clinical Electrophysiology, 20, 2072–2076.

  8. 8.

    Tada, H., Naito, S., Taniguchi, K., & Nogami, A. (2003). Concealed left anterior accessory pathways: Two approaches for successful ablation. Journal of Cardiovascular Electrophysiology, 14, 204–208.

  9. 9.

    Miyauchi, Y., Kobayashi, Y., Morita, N., et al. (2004). Successful radiofrequency catheter ablation of an anteroseptal (superoparaseptal) atrioventricular accessory pathway from the left ventricular outflow tract. Pacing and Clinical Electrophysiology, 27, 668–670.

  10. 10.

    Wit, A. L., & Cranefield, P. F. (1976). Triggered activity in cardiac muscle fibers of the simian mitral valve. Circulation Research, 38, 85–98.

  11. 11.

    Gonzalez, M. D., Contreras, L. J., Jongbloed, M. R., Rivera, J., Donahue, T. P., Curtis, A. B., et al. (2004). Left atrial tachycardia originating from the mitral annulus–aorta junction. Circulation, 110(20), 3187–3192.

  12. 12.

    Ouyang, F., Ma, J., Ho, S. Y., Bänsch, D., Schmidt, B., Ernst, S., et al. (2006). Focal atrial tachycardia originating from the non-coronary aortic sinus: Electrophysiological characteristics and catheter ablation. Journal of the American College of Cardiology, 48(1), 122–131.

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Correspondence to Riccardo Cappato.

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Ali, H., Vitali-Serdoz, L., Ferrero, P. et al. An unusual case of permanent junctional reciprocating tachycardia: Successful ablation at the mitral annulus-aorta junction. J Interv Card Electrophysiol 23, 213–217 (2008). https://doi.org/10.1007/s10840-008-9299-x

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Keywords

  • Radiofrequency
  • Catheter ablation
  • PJRT