Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node

A 70-year-old female presented with incessant supraventricular tachycardia that was refractory to metoprolol and sotalol. ECG revealed a narrow complex tachycardia with a rate of 163 beats per minute with a short RP relationship. She had salvos of atrial tachycardia which led to a severe reduction i...

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Main Authors: Anvi Raina, Nicholas Y. Tan, Olubadewa A. Fatunde, Samuel J. Asirvatham, Christopher V. DeSimone
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-05-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2023.1143409/full
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author Anvi Raina
Nicholas Y. Tan
Olubadewa A. Fatunde
Samuel J. Asirvatham
Christopher V. DeSimone
author_facet Anvi Raina
Nicholas Y. Tan
Olubadewa A. Fatunde
Samuel J. Asirvatham
Christopher V. DeSimone
author_sort Anvi Raina
collection DOAJ
description A 70-year-old female presented with incessant supraventricular tachycardia that was refractory to metoprolol and sotalol. ECG revealed a narrow complex tachycardia with a rate of 163 beats per minute with a short RP relationship. She had salvos of atrial tachycardia which led to a severe reduction in ejection fraction as noted on echocardiography and hemodynamic instability. An electrophysiological study was performed, and findings suggested this to be an atrial tachycardia with earliest activation in the perinodal area. Radiofrequency ablation was carried out along the septum and associated structures to surround this region including the right atrium, non-coronary sinus of Valsalva, and the left atrium (anterior wall outside of the right superior pulmonary vein) to isolate this area and surround the focus with ablation lesions. The patient has done well post-procedure and continues to do well without any recurrence on low-dose flecainide at 8 months.
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spelling doaj.art-04e026af378d435e9c4a629a3ae9c6572023-05-19T06:12:53ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-05-011010.3389/fcvm.2023.11434091143409Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic nodeAnvi Raina0Nicholas Y. Tan1Olubadewa A. Fatunde2Samuel J. Asirvatham3Christopher V. DeSimone4Department of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United StatesDepartment of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United StatesDepartment of Cardiovascular Medicine, Mayo Clinic College of Medicine, Phoenix, AZ, United StatesDepartment of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United StatesDepartment of Cardiovascular Medicine, Mayo Clinic College of Medicine, Rochester, MN, United StatesA 70-year-old female presented with incessant supraventricular tachycardia that was refractory to metoprolol and sotalol. ECG revealed a narrow complex tachycardia with a rate of 163 beats per minute with a short RP relationship. She had salvos of atrial tachycardia which led to a severe reduction in ejection fraction as noted on echocardiography and hemodynamic instability. An electrophysiological study was performed, and findings suggested this to be an atrial tachycardia with earliest activation in the perinodal area. Radiofrequency ablation was carried out along the septum and associated structures to surround this region including the right atrium, non-coronary sinus of Valsalva, and the left atrium (anterior wall outside of the right superior pulmonary vein) to isolate this area and surround the focus with ablation lesions. The patient has done well post-procedure and continues to do well without any recurrence on low-dose flecainide at 8 months.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1143409/fullperinodal atrial tachycardiasupraventricular tachycardia (SVT)retroaortic nodecatheter ablationelectrophysiology study
spellingShingle Anvi Raina
Nicholas Y. Tan
Olubadewa A. Fatunde
Samuel J. Asirvatham
Christopher V. DeSimone
Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node
Frontiers in Cardiovascular Medicine
perinodal atrial tachycardia
supraventricular tachycardia (SVT)
retroaortic node
catheter ablation
electrophysiology study
title Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node
title_full Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node
title_fullStr Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node
title_full_unstemmed Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node
title_short Case report: A case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node
title_sort case report a case of perinodal atrial tachycardia and review of the relevant clinical anatomy surrounding the retroaortic node
topic perinodal atrial tachycardia
supraventricular tachycardia (SVT)
retroaortic node
catheter ablation
electrophysiology study
url https://www.frontiersin.org/articles/10.3389/fcvm.2023.1143409/full
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