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Updated: Feb 5, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Reentrant atrial tachycardia after catheter ablation of coronary sinus accessory pathway
Koichi Watanabe1, Hidehiro Iwakawa1, Ken Terata1
1Department of Cardiovascular Medicine, Akita University Graduate School of Medicine, Akita, Japan.
Abstract:
Some patients require radiofrequency catheter ablation (RFCA) within the coronary sinus (CS) to eliminate conduction through accessory pathways (APs). A 23-year-old man was diagnosed with atrioventricular reentrant tachycardia (AVRT) utilizing a left-sided AP as the retrograde limb and was successfully treated by RFCA within the CS. Following the RFCA, another form of narrow QRS complex tachycardia was observed, and an electrophysiology study revealed the tachycardia as reentrant atrial tachycardia (AT) involving the CS. RFCA within the CS successfully terminated the tachycardia. This is the first case of iatrogenic reentrant AT secondary to RFCA for AVRT.
Learning Objective:
Radiofrequency catheter ablation (RFCA) is the standard treatment for atrioventricular reentrant tachycardia (AVRT) caused by accessory pathways. This case highlights that patients with AVRT who have undergone extensive RF applications may develop recurrent reentrant atrial tachycardia. Operators need to be aware that extensive RF applications can generate arrhythmogenic substrates, even in patients with AVRT.
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