CASE PRESENTATION

Fellow 廖敏村 / VS 游治節

Ectopic Paroxysmal Atrial Tachycardia

Cardiovascular Division, Departments of Internal

National Taiwan University Hospital, Taipei, Taiwan

A 45-year-old female

presented with progressive

palpitation in recent one year

Brief history

2010/10 OPD for palpitation

Holter: total 3738 SVEs (3.5%), atrial pairs: 881

No medical control

Free T4 0.999 ng/dL

2011/10 ER for palpitation

ECG: multiple APCs

Holter Total 32282 SVEs (30.1%)

424 atrial runs, longest 7 beats, fastest 136bpm

5393 atrial pairs

ECG

Multiple APCs

Holter

Atrial bigeminy

Holter

Atrial run

Holter

Atrial run with group

Holter

Long-pause 3.6 sec

UCG report 2011/10/13

Ao 24 mm (20-37) IVS 7 mm (7-10)

AV 16 mm (16-26) LVPW 8 mm (8-13)

LA 36 mm (19-40) LVEDD 43 mm (35-53)

RV 16 mm (5-21) LVESD 26 mm (20-35)

LVEF: 70.6%(M-mode)

Mitral valve prolapse, anterior leaflet

Mild MR

Mild to moderate TR

UCG

CXR

EPS tracing (2011/11)

EPS tracing (2011/11)

CARTO mapping

RAO LAO

RFCA

Anterior lateral site of RA ( above the roof of

appendage)

Repeat Holter 2 months later

Thank you for your attention