1. Ectopic Paroxysmal Atrial Tachycardia
Cardiovascular Division, Departments of Internal
National Taiwan University Hospital, Taipei, Taiwan
CASE PRESENTATION
Fellow 廖敏村 / VS 游治節

2. A 45-year-old female
presented with progressive
palpitation in recent one year

3. 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
 Total32282 SVEs (30.1%)
 424 atrial runs, longest 7 beats, fastest 136bpm
 5393 atrial pairs

4. ECG
 Multiple APCs

5. Holter
 Atrial bigeminy

6. Holter
 Atrial run

7. Holter
 Atrial run with group

8. Holter
 Long-pause 3.6 sec

9. 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

10. UCG

11. CXR

12. EPS tracing (2011/11)

13. EPS tracing (2011/11)

14. CARTO mapping
 RAO LAO

15. RFCA
 Anterior lateral site of RA ( above the roof of
appendage)

16. Repeat Holter 2 months later

17. Thank you for your attention