Using the 12‐Lead ECG to Localize the Origin of Ventricular and Atrial Tachycardias: Part 1. Focal Atrial Tachycardia: CME
Abstract
Focal atrial tachycardia is an unusual form of supraventricular tachycardia arising from defined anatomic locations and sites within the atria. Although recent advances in mapping technology have facilitated successful ablation, the surface ECG remains an important aid in localizing the focus. This review discusses the use of P-wave morphology on surface ECG to localize the site of focal atrial tachycardia.
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Focal AT may arise from any site in both atria, but crista terminalis, tricuspid and mitral valve annulus, and thoracic veins joining the atria are sites of predilection.
“Focal AT may arise from any site in both atria, but crista terminalis, tricuspid and mitral valve annulus, and within the thoracic veins joining to the atria, are sites of predilection.101”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [101]
In normal heart and absence of previous ablation, usual ECG localization rules apply for focal AT.
“In normal heart and in absence of previous ablation, the usual ECG localization rules apply.101”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [101]
Cites
P-Wave Morphology in Focal Atrial Tachycardia
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Self-citationKalman, J. M., Olgin, J. E., KARCH, M. R., Hamdan, M. H., Lee, R. J., & Lesh, M. D. (1998) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(97)00492-0 · Cited by 343 · see citing works
Self-citationUse of P wave configuration during atrial tachycardia to predict site of origin
Tang, C. W., Scheinman, M. M., Hare, G. F. V., Epstein, L. M., Fitzpatrick, A. P., Lee, R. J., & Lesh, M. D. (1995) · Journal of the American College of Cardiology · doi:10.1016/0735-1097(95)00307-x · Cited by 268 · see citing works
Focal Atrial Tachycardia Originating From the Non-Coronary Aortic Sinus
Ouyang, F. O., Ma, J., Ho, S. Y., Bänsch, D., Schmidt, B., Ernst, S., Kück, K., Liu, S., Huang, H., Chen, M., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.02.053 · Cited by 173 · see citing works
Morton, J. B., Sanders, P., DAS, A., Vohra, J. K., SPARKS, P. B., & Kalman, J. M. (2001) · Journal of Cardiovascular Electrophysiology · doi:10.1046/j.1540-8167.2001.00653.x · Cited by 158 · see citing works
Self-citationFocal Atrial Tachycardia From the Ostium of the Coronary Sinus
Kistler, P. M., Fynn, S. P., Haqqani, H. M., Stevenson, I., Vohra, J. K., Morton, J. B., SPARKS, P. B., & Kalman, J. M. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2005.01.042 · Cited by 122 · see citing works
Self-citationAtrial Tachycardias Originating from the Atrial Septum:
CHEN, C., TAI, C., Chiang, C., YU, W., Lee, S.-H., Chen, Y., HSIEH, M., Tsai, C., LEE, K., Ding, Y., et al. (2000) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2000.tb00045.x · Cited by 98 · see citing works
Yamada, T., Murakami, Y., Yoshida, Y., Okada, T., Yoshida, N., Toyama, J., Tsuboi, N., Inden, Y., Hirai, M., Murohara, T., et al. (2007) · Heart Rhythm · doi:10.1016/j.hrthm.2007.06.008 · Cited by 98 · see citing works
Roberts‐Thomson, K. C., Kistler, P. M., Haqqani, H. M., McGavigan, A. D., Hillock, R. J., Stevenson, I., Morton, J. B., Vohra, J. K., SPARKS, P. B., & Kalman, J. M. (2007) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2006.00754.x · Cited by 94 · see citing works
Self-citationTada, H., Nogami, A., Naito, S., et al. (1998) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.1998.tb01196.x · Cited by 80 · see citing works
YUN‐LONG, W., Li, X., XIN, Q., JIN‐XIN, M., PING, Z., YUAN, X., Hai-cheng, Z., & JI‐HONG, G. (2007) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2007.00808.x · Cited by 68 · see citing works
Focal Atrial Tachycardia II: Management
Roberts‐Thomson, K. C., Kistler, P. M., & Kalman, J. M. (2006) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2006.00433.x · Cited by 51 · see citing works
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Katritsis, D. G., Boriani, G., Cosio, F. G., Hindricks, G., Jaïs, P., Josephson, M. E., Keegan, R., Kim, Y.-H., Knight, B. P., Kuck, K.-H., et al. (2017) · Europace · doi:10.1093/europace/euw301 · Cited by 188 · see citing works
- Authors
- TEH, A. W., KISTLER, P. M., & KALMAN, J. M.
- Affiliations
- The Royal Melbourne Hospital (AU)
- Venue
- Journal of Cardiovascular Electrophysiology
- Publisher
- Wiley
- Published
- 2009-06
- Volume
- 20
- Issue
- 6
- Pages
- 706-709
- ISSN
- 1045-3873 (ISSN-L)
- 1540-8167
- OpenAlex
- W2141510131
- Cited by
- 43
- References
- 12
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 2 · 2019: 5 · 2017: 2 · 2016: 2 · 2015: 1 · 2014: 2 · 2013: 3 · 2012: 10
- FWCI
- 3.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cardiovascular Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › ECG Monitoring and Analysis
- Keywords
- focal atrial tachycardia, 12-lead ECG, P wave morphology, supraventricular tachycardia, arrhythmia localization, atrial tachycardia, catheter ablation
- MeSH terms
- Electrocardiography, Humans, Tachycardia, Ectopic Atrial, Tachycardia, Ventricular
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