Arrhythmogenic right ventricular cardiomyopathy and left atrial tachycardia: a case report

Little is known about atrial arrhythmias in arrhythmogenic right ventricular cardiomyopathy (ARVC). A 46-year-old man with definite ARVC presented with palpitations and exertional dyspnoea. Electrocardiogram showed a supraventricular tachycardia. Despite no prior cardiac surgery or atrial fibrillation ablation, electrophysiological study revealed a left atrial (LA) re-entrant circuit characterized by a slow fractionated potential bounded by two areas of double potentials giving a figure-of-eight pattern on activation map. Located on the LA roof within a zone of low bipolar voltages, this unusual substrate can be associated with a primitive atrial myopathy in ARVC.