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Updated: May 8, 2026

Electrophysiological Assessment of Murine Atria with High-Resolution Optical Mapping
Published on: February 22, 2018
Focal para-hisian atrial tachycardia with dual exits
M Lawrance Jesuraj1, K Sharada, C Sridevi
1Consultant, Department of Cardiology, CARE Institute of Medical Sciences, Hyderabad 500034, India.
Abstract:
Focal atrial tachycardias (AT) in the right atrium (RA) tend to cluster around the crista terminalis, coronary sinus (CS) region, tricuspid annulus, and para-hisian region. In most cases, the AT focus can be identified by careful activation mapping, and completely eliminated by radiofrequency (RF) catheter ablation. However, RF ablation near the His bundle (HB) carries a risk of inadvertent damage to the atrioventricular (AV) conduction system. Here we describe a patient with an AT originating in the vicinity of the AV node, which was successfully ablated earlier from non-coronary aortic cusp (NCC), and recurred with an exit from para-hisian location. Respiratory excursions of the catheter were associated with migration to the area of HIs. This was successfully ablated during controlled apnoea, using 3D electroanatomic mapping.
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