摘要
Background:Epicardial roof-dependent atrial tachycardia is rare among macroreentrant tachycardias.The importance of epicardial structure or fiber involving septopulmonary bundle(SPB)has not been realized generally.Case presentation:A 74-year-old woman who underwent catheter ablation of atrial fibrillation previously accepted a second-time radiofrequency ablation due to atrial flutter.The mapping and entrainment results of the tachycardia tended to be an epicardial SPB-dependent macroreentrant atrial tachycardia and it was ablated to sinus rate at the first single targeting site,just located in the breakout site of SPB into the posterior wall(PW)of left atrial(LA).The twice-activation mapping of PW of LA also proved the presence of SPB.No recurrent arrhythmia was seen at follow-up at 3 months.Conclusion:In this case,an uncommon phenomenon was observed post-ablation for persistent atrial fibrillation,where the epicardial muscular structure of the LA-SPB was involved in atypical atrial flutter.This should be considered as a potential factor in such cases.Further similar cases may be required to improve diagnostic accuracy and to formulate effective ablation strategies for this type of tachycardia.
基金
supported in part by the Key Medical and Health Specialty Construction Project of Anhui Province.
