Low right atrial tachycardia with positive P waves in the inferior leads: explanation by electroanatomical mapping

J Interv Card Electrophysiol. 2006 Apr;15(3):201-2. doi: 10.1007/s10840-006-9001-0. Epub 2006 Aug 4.

Abstract

The P-wave morphology can help trying to localize the origin of an ectopic atrial tachycardia noninvasively. We describe the case of a 54-year-old male patient with an ectopic right atrial tachycardia and positive P waves in the inferior leads on a 12 lead ECG. Electroanatomical mapping with the CARTO system localized the focus at the low right atrial free wall. With that origin and a very slow conduction through the cavotricuspid isthmus the activation spread clockwise around the tricuspid anulus and resulted in a craniocaudal septal activation pattern, which subsequently caused a positive P-wave morphology in the inferior leads.

Publication types

  • Case Reports

MeSH terms

  • Body Surface Potential Mapping / methods*
  • Humans
  • Male
  • Middle Aged
  • Tachycardia, Ectopic Atrial / diagnosis*