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Published in: Heart and Vessels 2/2012

01-03-2012 | Case Report

Adenosine-induced atrial tachycardia and multiple foci initiating atrial fibrillation eliminated by catheter ablation using a non-contact mapping system

Authors: Mika Hioki, Seiichiro Matsuo, Teiichi Yamane, Ken-ichi Tokutake, Keiichi Ito, Ryohsuke Narui, Shin-ichi Tanigawa, Seigo Yamashita, Michifumi Tokuda, Keiichi Inada, Taro Date, Michihiro Yoshimura

Published in: Heart and Vessels | Issue 2/2012

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Abstract

A 47-year-old male with both atrial tachycardia and atrial fibrillation underwent catheter ablation. During the procedure, rapid administration of adenosine triphosphate induced atrial tachycardia. A non-contact mapping system revealed a focal atrial tachycardia originating from the lateral right atrium, which was successfully ablated. Following the ablation of tachycardia, atrial fibrillation was induced by the injection of adenosine along with multiple extra pulmonary vein foci, which were eliminated by the application of radiofrequency under the guidance of a non-contact mapping system.
Literature
1.
go back to reference Strickberger SA, Man KC, Daoud EG, Goyal R, Brinkman K, Knight BP, Weiss R, Bahu M, Morady F (1997) Adenosine-induced atrial arrhythmia: a prospective analysis. Ann Intern Med 127:417–422PubMed Strickberger SA, Man KC, Daoud EG, Goyal R, Brinkman K, Knight BP, Weiss R, Bahu M, Morady F (1997) Adenosine-induced atrial arrhythmia: a prospective analysis. Ann Intern Med 127:417–422PubMed
2.
go back to reference Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT (1996) Adenosine-induced atrial fibrillation. Am J Emerg Med 14:300–301PubMedCrossRef Silverman AJ, Machado C, Baga JJ, Meissner MD, Lehmann MH, Steinman RT (1996) Adenosine-induced atrial fibrillation. Am J Emerg Med 14:300–301PubMedCrossRef
3.
go back to reference Sumitomo N, Nakamura T, Fukuhara J, Nakai T, Watanabe I, Mugishima H, Hiraoka M (2010) Clinical effectiveness of pulmonary vein isolation for arrhythmic events in a patient with catecholaminergic polymorphic ventricular tachycardia. Heart Vessels 25:448–452PubMedCrossRef Sumitomo N, Nakamura T, Fukuhara J, Nakai T, Watanabe I, Mugishima H, Hiraoka M (2010) Clinical effectiveness of pulmonary vein isolation for arrhythmic events in a patient with catecholaminergic polymorphic ventricular tachycardia. Heart Vessels 25:448–452PubMedCrossRef
4.
go back to reference Tokuda M, Yamane T, Matsuo S, Ito K, Narui R, Hioki M, Tanigawa SI, Nakane T, Yamashita S, Inada K, Shibayama K, Miyanaga S, Yoshida H, Miyazaki H, Date T, Sugimoto KI, Yoshimura M (2011) Different strategies for performing pulmonary vein isolation in patients with pulmonary vein rhythm. Heart Vessels. doi: 10.1007/S00380-010-0113-1 Tokuda M, Yamane T, Matsuo S, Ito K, Narui R, Hioki M, Tanigawa SI, Nakane T, Yamashita S, Inada K, Shibayama K, Miyanaga S, Yoshida H, Miyazaki H, Date T, Sugimoto KI, Yoshimura M (2011) Different strategies for performing pulmonary vein isolation in patients with pulmonary vein rhythm. Heart Vessels. doi: 10.​1007/​S00380-010-0113-1
5.
go back to reference Lee SH, Tai CT, Hsieh MH, Tsao HM, Lin YJ, Chang SL, Huang JL, Lee KT, Chen YJ, Cheng JJ, Chen SA (2005) Predictors of non-pulmonary vein ectopic beats initiating paroxysmal atrial fibrillation: implication for catheter ablation. J Am Coll Cardiol 46:1054–1059PubMedCrossRef Lee SH, Tai CT, Hsieh MH, Tsao HM, Lin YJ, Chang SL, Huang JL, Lee KT, Chen YJ, Cheng JJ, Chen SA (2005) Predictors of non-pulmonary vein ectopic beats initiating paroxysmal atrial fibrillation: implication for catheter ablation. J Am Coll Cardiol 46:1054–1059PubMedCrossRef
6.
go back to reference Maeda S, Iesaka Y, Uno K, Otomo K, Nagata Y, Suzuki K, Hachiya H, Goya M, Takahashi A, Fujiwara H, Hiraoka M, Isobe M (2011) Complex anatomy surrounding the left atrial posterior wall: analysis with 3D computed tomography. Heart Vessels. doi: 10.1007/S00380-011-0120-x Maeda S, Iesaka Y, Uno K, Otomo K, Nagata Y, Suzuki K, Hachiya H, Goya M, Takahashi A, Fujiwara H, Hiraoka M, Isobe M (2011) Complex anatomy surrounding the left atrial posterior wall: analysis with 3D computed tomography. Heart Vessels. doi: 10.​1007/​S00380-011-0120-x
7.
go back to reference Hilbert S, Dagres N, Hindricks G, Sommer P, Gaspar T, Rallidis LS, Kremastinos DT, Piorkowski C (2011) Rapid ventricular pacing: a fast, reliable, and safe technique for optimization of image acquisition during rotational angiography for catheter ablation of atrial fibrillation. Heart Vessels 26:349–352. doi:10.1007/S00380-010-0023-2 Hilbert S, Dagres N, Hindricks G, Sommer P, Gaspar T, Rallidis LS, Kremastinos DT, Piorkowski C (2011) Rapid ventricular pacing: a fast, reliable, and safe technique for optimization of image acquisition during rotational angiography for catheter ablation of atrial fibrillation. Heart Vessels 26:349–352. doi:10.​1007/​S00380-010-0023-2
8.
go back to reference Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Métayer P, Clémenty J (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666PubMedCrossRef Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Métayer P, Clémenty J (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666PubMedCrossRef
9.
go back to reference Kanei Y, Hanon S, Van-Tosh A, Schweitzer P (2008) Adenosine-induced atrial fibrillation during pharmacologic stress testing: report of eight cases and review of the literature. Int J Cardiol 129:e15–e17PubMedCrossRef Kanei Y, Hanon S, Van-Tosh A, Schweitzer P (2008) Adenosine-induced atrial fibrillation during pharmacologic stress testing: report of eight cases and review of the literature. Int J Cardiol 129:e15–e17PubMedCrossRef
10.
go back to reference Jiang CY, Jiang RH, Matsuo S, Fu GS (2010) ATP revealed extra pulmonary vein source of atrial fibrillation after circumferential pulmonary vein isolation. Pacing Clin Electrophysiol 33:248–251PubMedCrossRef Jiang CY, Jiang RH, Matsuo S, Fu GS (2010) ATP revealed extra pulmonary vein source of atrial fibrillation after circumferential pulmonary vein isolation. Pacing Clin Electrophysiol 33:248–251PubMedCrossRef
11.
go back to reference Coumel P (1996) Autonomic influences in atrial tachyarrhythmias. J Cardiovasc Electrophysiol 7:999–1007PubMedCrossRef Coumel P (1996) Autonomic influences in atrial tachyarrhythmias. J Cardiovasc Electrophysiol 7:999–1007PubMedCrossRef
12.
go back to reference Zimmermann M, Kalusche D (2001) Fluctuation in autonomic tone is a major determinant of sustained atrial arrhythmias in patients with focal ectopy originating from the pulmonary veins. J Cardiovasc Electrophysiol 12:285–291PubMedCrossRef Zimmermann M, Kalusche D (2001) Fluctuation in autonomic tone is a major determinant of sustained atrial arrhythmias in patients with focal ectopy originating from the pulmonary veins. J Cardiovasc Electrophysiol 12:285–291PubMedCrossRef
13.
go back to reference Lerman BB, Belardinelli L (1991) Cardiac electrophysiology of adenosine. Basic and clinical concepts. Circulation 83:1499–1509PubMed Lerman BB, Belardinelli L (1991) Cardiac electrophysiology of adenosine. Basic and clinical concepts. Circulation 83:1499–1509PubMed
14.
go back to reference Yamaguchi T, Tsuchiya T, Miyamoto K, Nagamoto Y, Takahashi N (2010) Characterization of non-pulmonary vein foci with an EnSite array in patients with paroxysmal atrial fibrillation. Europace 12:1698–1706PubMedCrossRef Yamaguchi T, Tsuchiya T, Miyamoto K, Nagamoto Y, Takahashi N (2010) Characterization of non-pulmonary vein foci with an EnSite array in patients with paroxysmal atrial fibrillation. Europace 12:1698–1706PubMedCrossRef
15.
go back to reference Matsuo S, Yamane T, Date T, Inada K, Kanzaki Y, Tokuda M, Shibayama K, Miyanaga S, Miyazaki H, Sugimoto K, Mochizuki S (2007) Reduction of AF recurrence after pulmonary vein isolation by eliminating ATP-induced transient venous re-conduction. J Cardiovasc Electrophysiol 18:704–708PubMedCrossRef Matsuo S, Yamane T, Date T, Inada K, Kanzaki Y, Tokuda M, Shibayama K, Miyanaga S, Miyazaki H, Sugimoto K, Mochizuki S (2007) Reduction of AF recurrence after pulmonary vein isolation by eliminating ATP-induced transient venous re-conduction. J Cardiovasc Electrophysiol 18:704–708PubMedCrossRef
16.
go back to reference Hachiya H, Hirao K, Takahashi A, Nagata Y, Suzuki K, Maeda S, Sasaki T, Kawabata M, Isobe M, Iesaka Y (2007) Clinical implication of reconnection between the left atrium and isolated pulmonary vein provoked by adenosine triphosphate after extensive encircling pulmonary vein isolation. J Cardiovasc Electrophysiol 18:1–7CrossRef Hachiya H, Hirao K, Takahashi A, Nagata Y, Suzuki K, Maeda S, Sasaki T, Kawabata M, Isobe M, Iesaka Y (2007) Clinical implication of reconnection between the left atrium and isolated pulmonary vein provoked by adenosine triphosphate after extensive encircling pulmonary vein isolation. J Cardiovasc Electrophysiol 18:1–7CrossRef
Metadata
Title
Adenosine-induced atrial tachycardia and multiple foci initiating atrial fibrillation eliminated by catheter ablation using a non-contact mapping system
Authors
Mika Hioki
Seiichiro Matsuo
Teiichi Yamane
Ken-ichi Tokutake
Keiichi Ito
Ryohsuke Narui
Shin-ichi Tanigawa
Seigo Yamashita
Michifumi Tokuda
Keiichi Inada
Taro Date
Michihiro Yoshimura
Publication date
01-03-2012
Publisher
Springer Japan
Published in
Heart and Vessels / Issue 2/2012
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-011-0159-8

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