Author + information
- Received April 28, 2013
- Revision received June 4, 2013
- Accepted June 11, 2013
- Published online December 17, 2013.
- Tatsuya Hayashi, MD∗,
- Shigeto Naito, MD‡,
- Koji Kumagai, MD‡,
- Shigeru Ohshima, MD‡,
- Hitoshi Hachiya, MD†,
- Kenzo Hirao, MD† and
- Mitsuaki Isobe, MD∗
A 28-year-old man underwent catheter ablation for ventricular tachycardia (VT). Ultrasound revealed a right atrial diverticulum posterior to the left ventricle (LV), measuring 56 × 33 mm (A, Online Video 1). Compression and impairment of wall motion of the LV were noted on contrast-enhanced computed tomography (B), right atriography, and left ventriculography (C and D, Online Video 2). When clinical VT could not be induced during the catheter ablation procedure, pacemapping was used. Pacemapping was poor in the endocardium of the LV, but good capture was achieved on the epicardial side, using access from inside the diverticulum (E and F). Radiofrequency current applications were delivered at this site, and the patient has been free of VT for >3 years.
To the best of our knowledge, this is the first report of a right atrial diverticulum accompanied by VT. VT may be one of the causes of sudden cardiac death in patients with a right atrial diverticulum. AP = anterior posterior; CS = coronary sinus; HBE = His bundle; LA = left atrium; LAO = left anterior oblique; LV = left ventricle; PA = posterior anterior; RA = right atrium; RAD = right atrial diverticulum; RVA = right ventricular apex.
- Received April 28, 2013.
- Revision received June 4, 2013.
- Accepted June 11, 2013.
- American College of Cardiology Foundation