New Discovery of Left Atrial Macroreentry Tachycardia: Originating from the Spontaneous Scarring of Left Atrial Anterior Wall

Figure 1

Left atrial macroreentry tachycardia promoted by anterior scar. (a) The low voltage areas were not found in RA. (b) A nonreentrant activation with the earliest site in the atrial septum and the total activation time in the RA < 90% of the TCL. (c) Bipolar voltage map of the left atrium in anterior-posterior and posterior-anterior wall (insets). A central scar was seen in left atrial anterior wall (LAAW). (d) Left atrial activation maps of the patients with a double-loop reentry, a counterclockwise loop around the mitral valve (white solid lines), and a clockwise loop (white dotted lines) around the scar of LAAW. SVC: superior vena cava; TA: tricuspid annulus; LAA: left atrial appendage; MV: mitral valve; RSPV: right superior pulmonary vein; LAAW: left atrial anterior wall.

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