RADIOFREQUENCY ABLATION IN CHRONIC ECTOPI C LEFT-ATRIAL TACHYCARDIA

History and findings: A 35-year-old symptom-free woman was known since childhood to have an increased resting heart rate (130-150/min). In t he ECG there was a negative P in leads I and aVL, with a shortened P-Q interval of 90 ms. Previous treatment with beta-receptor blockers and calcium antagonists had failed. Clinical examination and echocardiogr aphy, as well as levels of thyroid hormone were unremarkable. During e lectrophysiological studies the earliest atrial activity was localised by endocardial leads in the region of the distal coronary sinus and t he arrhythmia could not be terminated by atrial over-stimulation. Trea tment and course: After transseptal puncture the ablation catheter was introduced into the left atrium and, the exact site of the origin of the atrial tachycardia having been established, radiofrequency ablatio n of this point was successfully performed. Subsequently the patient w as always found to be in stable sinus rhythm at around 80/min. Conclus ion: To prevent tachycardia-induced cardiomyopathy: radiofrequency abl ation can be indicated even in symptom-free patients with atrial tachy cardia.