Document Detail


Atrial activation mapping in sinus rhythm in the clinical electrophysiology laboratory: observations during Bachmann's bundle block.
MedLine Citation:
PMID:  15149420     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: The high posterolateral right atrium (RA) is considered the "sinus node area," but we lack information on endocardial atrial activation in sinus rhythm. We studied RA and left atrial (LA) endocardial activation in the electrophysiology laboratory. METHODS AND RESULTS: Thirty-five patients (21 men) aged 47 +/- 16.4 years (mean +/- SD) underwent RA mapping (22.2 +/- 3.8 points). In 21 patients, LA activation was mapped (11.1 +/- 3.9 points) through the coronary sinus (CS), right pulmonary artery, and/or a patent oval foramen. Fourteen patients had atrial arrhythmias, and 3 an ECG pattern of Bachmann's bundle block. Endocardial RA activation preceded P wave in 5 (-14 +/- 4.2 ms), coincided in 11, and followed P onset in 18 (16.7 +/- 6.6 ms). Location of the zero point varied from the superior vena cava to the low RA and from lateral to paraseptal RA. In 19 patients, activation started simultaneously in 2 to 5 points located >or=1 cm apart. RA activation was descending in most, but in 3 with low onset there was collision in the anterior and septal walls. In 15 of 21 patients, descending LA activation dominated, ending in the mid CS in 12, proximal CS in 1, and simultaneously throughout the CS in 2. In 3 with Bachmann's bundle block, CS activation was ascending and in 2 double potentials were recorded from the LA roof. CONCLUSION: During stable sinus rhythm, RA activation can start in different areas or simultaneously over large areas resulting in different activation patterns, both in the RA and the LA. LA activation is predominantly descending, but in Bachmann's bundle block it becomes ascending, and double potentials suggest a location of block in the LA roof.
Authors:
Francisco G Cosío; Arturo Martín-Peñato; Agustín Pastor; Ambrosio Núñez; María Antonia Montero; Carina P Cantale; Salomao Schames
Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  15     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-19     Completed Date:  2004-09-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  524-31     Citation Subset:  IM    
Affiliation:
Cardiology Service, Hospital Universitario de Getafe, Madrid, Spain. fcosio@vitanet.nu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arrhythmia, Sinus / diagnosis,  physiopathology*
Body Surface Potential Mapping / methods*
Bundle-Branch Block / diagnosis,  physiopathology*
Female
Heart Atria / physiopathology*
Heart Conduction System / physiopathology
Humans
Male
Middle Aged
Sinoatrial Block / diagnosis,  physiopathology*
Sinoatrial Node / physiopathology*

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


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