Respiratory cycle–dependent atrial tachycardia: Prevalence, electrocardiographic and electrophysiologic characteristics, and outcome after catheter ablation

Clinical and electrophysiological features of respiratory cycle–dependent atrial tachycardia: An analysis of three cases

“…They reported that RCAT appeared to arise from the right pulmonary vein and superior vena cava, and suggested that the mechanism of RCAT was triggered by autonomic nervous system activity modulated by respiration or chest movement itself. In 1 of our cases, RCAT originated from the right pulmonary venous antrum, near the area described in this previous study, 8 but the earliest sites of the other 2 cases were localized to the left posterior atrium and low lateral right atrium. Thus, RCAT can appear from a wider area of the atrium than was previously thought.…”

“…The first case of RCAT was described by Takatsuki and colleagues 5 in 2001, coexisting with Wolff-Parkinson-White syndrome and treated by RFCA, and there have been several subsequent reports of RCAT. 6 , 7 Yamamoto and colleagues 8 demonstrated precisely the clinical characteristics, geometry of origin, EPS, and outcome of RFCA in 7 cases with 9 RCATs. They reported that RCAT appeared to arise from the right pulmonary vein and superior vena cava, and suggested that the mechanism of RCAT was triggered by autonomic nervous system activity modulated by respiration or chest movement itself.…”

Respiratory cycle-dependent left atrial tachycardia in a former Tour de France cyclist

“…In literature temporal vagal activation or pulmonary vein stretch by an increased venous return has been assumed as the cause of the arrhythmia. 3 In contrast to this hypothesis, we believe that adrenergic activation of triggers inside the pulmonary vein(s) is necessary for respiratory cycle-related atrial tachycardia since our patient reported an augmentation of palpitations during competition and exercise. Furthermore, the arrhythmia disappeared during sedation with propofol.…”

“…Respiratory cycle-dependent left atrial tachycardia occur infrequently in patients with symptomatic SVT and can be effectively treated with RFCA. 3 As shown with this example, they do also occur in athletes. Whether respiratory cycle-dependent left atrial tachycardia play a role as a trigger for AF in athletes warrants further investigations.…”

“…To date, only a few case reports and one case series dealing with such respiratory cycle-dependent arrhythmias have been published. 3 To our knowledge, no respiratory cycle-dependent atrial tachycardia in an athlete has been described in the literature.…”