Feeds:
Posts
Comments

Posts Tagged ‘how to localise atrial tachycardia’

What is the simplest and accurate way to predict  the   origin of Right atrial tachycardia(RAT)  from left atrial tachycardia(LAT) ?

Look at the P waves in V 1 ( Don’t look further ! )

  • A  negative  or  a biphasic (+/- ) P wave in V 1  is 100% specific  for a right atrial tachycardia
  • A positive P in V1 or  a biphasic ( –/+ ) P-wave in lead V1  has 100%  sensitivity  for a left atrial tachycardia

What are the incidence of left and right atrial tachycardia ?

RA- 75%

LA -25%

What are the common focus of right atrial tachycardia ?

  1. Crista terminalis (60% of all RAT)
  2. Tricuspid annulus
  3. Coronary sinus ostium
  4. Perinodal tissue
  5. Right side of IAS
  6. Right atrial appedage

What are the left atrial focus in Left atrial tachycardia ?

  1. Right & left pulmonary vein (50% of all LAT)
  2. Superior mitral annulus
  3. LAA
  4. CS body
  5. Left septum

(Please note  this rule is not applicable for re-entrant tachycardias, atrial flutter, AV nodal tachycardias)

Source :

P-Wave Morphology in Focal Atrial Tachycardia

Development of an Algorithm to Predict the Anatomic Site of Origin

peter M. Kistler  et all. 

This paper  from  Melburne, Australia is a rare gem of  an article for understanding  atrial tachycardia .This  paper won the  the Eric and Bonny Prystowsky Heart Rhythm  society Fellows Clinical Research Award, New Orleans, Louisiana, 2005.

Click on the Link  to reach the article

http://content.onlinejacc.org/cgi/content/full/48/5/1010

 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

//

Read Full Post »