Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/39098
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Type: Journal article
Title: Focal atrial tachycardia arising from the tricuspid annulus: electrophysiologic and electrocardiographic characteristics
Author: Morton, J.
Sanders, P.
Das, A.
Vohra, J.
Sparks, P.
Kalman, J.
Citation: Journal of Cardiovascular Electrophysiology, 2001; 12(6):653-659
Publisher: Futura Publ Co
Issue Date: 2001
ISSN: 1045-3873
1540-8167
Statement of
Responsibility: 
Joseph B. Morton, Prashanthan Sanders, Arvind Das, Jitendra K. Vohra, Paul B. Sparks, and Jonathan M. Kalman
Abstract: <h4>Introduction</h4>Focal right atrial tachycardia (RAT) arising from the crista terminalis, para-Hisian, and coronary sinus os regions are well described. Less information exists regarding RAT arising from the nonseptal region of the tricuspid annulus (TA).<h4>Methods and results</h4>From a consecutive series of 64 patients who had undergone successful radiofrequency ablation (RFA) of 67 RATs, the characteristics of 9 (13%) patients (6 men; mean age 50 +/- 20 years) with a TA focus were reviewed. The annular focus was localized to the inferoanterior TA in 7 and the superior TA in 2. Mean tachycardia cycle length was 371 +/- 66 msec. Mean activation time at the site of successful RFA in 9 of 9 patients was -43 +/- 11 msec. At 9.3 +/- 5.6 months of follow-up, 1 of 9 patients had recurrent tachycardia successfully treated with repeat RFA. In 7 of 9 patients with RAT from the inferoanterior TA, the surface ECG P wave morphology was upright in aVL, inverted in III and VI, and either inverted or biphasic with an initial negative deflection from V2 to V6.<h4>Conclusion</h4>The TA is an important site of origin of RAT. In the present study, the inferoanterior region of the TA was a preferential site of origin with resulting characteristic P wave morphology. Knowledge of this anatomic distribution and P wave morphology allows targeted mapping and may facilitate successful RFA.
Keywords: atrial tachycardia
tricuspid annulus
radiofrequency ablation
Rights: © 2001 by Futura Publishing Company, Inc.
DOI: 10.1046/j.1540-8167.2001.00653.x
Published version: http://dx.doi.org/10.1046/j.1540-8167.2001.00653.x
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