Adenosine-sensitive Atrial Tachycardia Originating from the Para-Hisian Region with the Entrance of a Slow Conduction Zone at the Noncoronary Aortic Sinus

Adenosine-sensitive atrial tachycardias (ATs) originating from the atrioventricular (AV) node vicinity have been reported, and the mechanism responsible is considered to be reentry.1 Previous reports have demonstrated manifest entrainment from the right atrium (RA)2–4 or mitral annulus (MA)4,5 during these ATs, and most of them could be ablated safely at the entrance of the slow conduction zone (SCZ), indicated by a manifest entrainment-guided strategy.2,3 We describe a case of adenosine-sensitive AT originating from the para-Hisian region that could be ablated at the entrance of the SCZ, indicated by the demonstration of manifest entrainment from the noncoronary aortic sinus (NCS).