Document Detail

High-resolution mapping around the eustachian ridge during typical atrial flutter.
MedLine Citation:
PMID:  17074007     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although the reentrant circuit of typical atrial flutter (AFL) has been well recognized, the activation around the Eustachian ridge (ER) has not been fully characterized. The aim of this study was to delineate the activation patterns around the ER during typical AFL using high-resolution noncontact mapping. METHODS: Fifty-three patients (M/F = 43/10, 62 +/- 14 years) with typical AFL were included. The high-resolution mapping of the right atrium using a noncontact mapping system during AFL and pacing from the coronary sinus (CS) was performed to evaluate the conduction through the ER. RESULTS: Three types of activation patterns around the ER could be classified according to the ER conduction during AFL and CS pacing. Type I (n = 21, M/F = 16/5, 61 +/- 13 years) exhibited conduction block at the ER during AFL and CS pacing. The local unipolar electrograms at the ER exhibited long double potentials (DPs) (109 +/- 12 ms, range 77-153 ms) during AFL and CS pacing (84 +/- 18 ms, range 48-129 ms). Type II (n = 8, M/F = 7/1, 61 +/- 15 years) exhibited conduction block at the ER during AFL, but conduction through the ER during CS pacing. The unipolar electrograms exhibited long DPs (119 +/- 12 ms, range 97-141 ms) at the ER during the tachycardia and an rS pattern during CS pacing. Type III (n = 24, M/F = 20/4, 61 +/- 16 years) exhibited an activation wavefront that passed along the ER, with the sinus venosa as the posterior barrier during AFL. During CS pacing, all cases exhibited conduction through the ER with an rS pattern. CONCLUSIONS: This study is the first to demonstrate the three patterns of activation along the ER during AFL and CS pacing. This finding suggested that the ER is an anatomic and functional barrier during typical AFL.
Jin-Long Huang; Ching-Tai Tai; Tu-Ying Liu; Yenn-Jiang Lin; Pi-Chang Lee; Chih-Tai Ting; Shih-Ann Chen
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  17     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-31     Completed Date:  2007-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1187-92     Citation Subset:  IM    
Heart Failure Division, Cardiovascular Center, Taichung Veterans General Hospital, Taipei, Taiwan.
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MeSH Terms
Atrial Flutter / diagnosis*,  physiopathology*
Body Surface Potential Mapping / methods*
Electrophysiologic Techniques, Cardiac / methods
Heart Atria
Heart Catheterization / methods
Heart Conduction System / physiology
Heart Septum / physiology*
Middle Aged

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

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