Radiofrequency Ablation of an Atrial Tachycardia Emanating From the Non-coronary Aortic Cusp Guided by an Electroanatomic Navigation System

We report on an atrial tachycardia (AT), emanating from the non-coronary (NC) aortic cusp, ablated with the aid of an electro-anatomical navigation system. In this setting, the electrocardiographic, electrophysiologic (EP), anatomical, and ablative considerations are discussed. Although NC aortic cusp focal ATs are an uncommon EP finding, their ablation is effective and safe, especially from an atrio-ventricular (AV) conductive point of view. This origin of AT must be invoked and systematically disclosed when a peri-AV nodal AT origin is suspected, in order to avoid a potentially harmful energy application at the vicinity of the AV conductive tissue.