Atrial tachycardia with widely-split P waves may mimic a distinct faster atrial tachycardia with half the cycle length of the actual P-P interval

Takumi Yamada, Harish Doppalapudi, H. Thomas McElderry, G. Neal Kay

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

A 57-year-old man with atrial tachycardia (AT) after cavo-tricuspid isthmus ablation underwent electrophysiological testing. Mapping revealed atrial activation with a cycle length exactly twice that of the P-P interval on electrocardiogram. Electroanatomic mapping revealed an AT focus near the left superior pulmonary vein, with inter-atrial conduction occurring in the lower septum and cavo-tricuspid isthmus conduction block. A propagation map demonstrated activation going down the left atrial posterior wall and right atrial free wall, generating different positive P waves in the inferior leads. The focal AT with inter- and intra-atrial conduction block exhibited widely-split P waves misinterpreted as a distinct AT.

Original languageEnglish (US)
Pages (from-to)1381-1384
Number of pages4
JournalCirculation Journal
Volume72
Issue number8
DOIs
StatePublished - 2008

Keywords

  • Focal atrial tachycardia
  • Inter-atrial conduction disturbance
  • Radiofrequency catheter ablation
  • Split P wave

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