Utility of Dual-Chamber Electrogram-Based Pace Mapping in a Teenager
with a Focal Atrial Tachycardia, Low Inducibility, and Indeterminate
Earliest Excitation Site
Abstract
A focal atrial tachycardia (FAT) with low inducibility can be
challenging to treat with catheter ablation. A 17-year-old female had
previously undergone an unsuccessful ablation due to low inducibility of
the tachycardia. During the second session, an activation map with a few
FAT was insufficient to identify the earliest activation site. However,
by employing a novel pace mapping technique using dual chamber unipolar
electrograms as a reference, we accurately identified the FAT origin and
successfully performed the ablation. This technique may enable effective
ablation with fewer radiofrequency applications in FAT where the
earliest excitation site cannot be clearly identified.