Document Detail


Atrial tachycardia arising adjacent to noncoronary aortic sinus: distinctive atrial activation patterns and anatomic insights.
MedLine Citation:
PMID:  20797494     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to determine whether atrial tachycardia arising adjacent to the noncoronary aortic sinus (NCAS-AT) has distinctive atrial activation patterns in relation to targeted anatomic imaging. BACKGROUND: The knowledge of atrial activation patterns of the NCAS-AT and its anatomic basis is very limited. METHODS: Three-dimensional electroanatomic mapping was performed during NCAS-AT in 13 patients and during sequentially pacing from the noncoronary aortic sinus (NCAS) and the para-Hisian atrial area in 15 reference patients. The spatial relationship between the NCAS and the contiguous atria was studied in another 25 reference patients using computed tomography and in 12 human hearts using gross and microscopic anatomic examination. RESULTS: During NCAS-AT, the para-Hisian area of the right atrium (RA) and the anteroseptal region of the left atrium were activated almost simultaneously. The initial activation area (within first 20 ms of atrial depolarization) was relatively wide (9.3 +/- 2.6 cm(2) on the RA map and 8.1 +/- 2.1 cm(2) on the left atrium map). In reference patients, NCAS pacing reproduced a biatrial activation pattern of NCAS-AT and resulted in a wider initial activation area than the para-Hisian atrial pacing within first 20 ms of RA activation (10.1 +/- 3.0 cm(2) vs. 3.9+/-1.7 cm(2); p < 0.001). Anatomically, the wall of NCAS did not contain myocardial tissue, but was intimately related to the paraseptal regions of the atria such that the shortest distances from the NCAS to the RA and the left atrium were 1.7 +/- 0.6 mm and 2.3 +/- 0.9 mm (p < 0.01), respectively. CONCLUSIONS: NCAS-AT has distinct atrial activation patterns that can be explained in part by its spatial anatomic relationship with the atria.
Authors:
Xingpeng Liu; Jianzeng Dong; Siew Yen Ho; Ashok Shah; Deyong Long; Ronghui Yu; Ribo Tang; Meleze Hocini; Michel Haissaguerre; Changsheng Ma
Related Documents :
19157164 - Differences in atrial electromechanical coupling and atrial volume in patients with idi...
1634684 - Activation patterns in experimental canine atrial flutter produced by right atrial crus...
12408264 - The electromechanical effects of pacing at different sites within the right atrium.
17609834 - A rare variant of ellis van creveld syndrome.
8990404 - Molecular biology of plasminogen activators: what are the clinical implications of drug...
21160164 - Contribution of ductus venosus doppler in first-trimester screening for major cardiac d...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  56     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  796-804     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Body Surface Potential Mapping
Bundle of His
Cardiac Pacing, Artificial
Electrocardiography
Female
Heart Atria / physiopathology
Humans
Male
Sinus of Valsalva / anatomy & histology,  physiopathology*
Tachycardia, Ectopic Atrial / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Does Elevated C-Reactive Protein Increase Atrial Fibrillation Risk? A Mendelian Randomization of 47,...
Next Document:  Calcium dynamics and the mechanisms of atrioventricular junctional rhythm.