Atrial tachycardias originated at the left atrial appendage (LAA) are uncommon; often they are incessant and might induce tachycardiomyopathy, as discussed by Hillock et al. (Heart Rhythm;3(4):467-469, 2006). A case of a 21-year-old woman with incessant atrial tachycardia is presented, refractory to medical therapy, echocardiography showed global dilation with LV ejection fraction of 20%. After two failed endocardial ablations, an epicardial access was attempted. The earliest activation site was located at the tip of the epicardial aspect of the LAA. RFCA was successful at this site. The patient remains asymptomatic during a follow-up of 10 months; the ventricular function was completely recovered after 6 months (LVEF of 50%).
Keywords: Electro-anatomical mapping system; Epicardial ablation; Incessant atrial tachycardia; Left atrial appendage; Radiofrequency catheter ablation.
© 2021. Springer Science+Business Media, LLC, part of Springer Nature.