Document Detail


Prospective observations in the clinical and electrophysiological characteristics of intra-isthmus reentry.
MedLine Citation:
PMID:  20455984     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: Intra-isthmus reentry (IIR) is a circuit within the cavotricuspid isthmus (CTI). The purpose of this study is to prospectively define the electrogram and surface ECG characteristics of IIR, and its clinical implications.
METHODS AND RESULTS: Fourteen patients underwent electrophysiological studies and were found to have IIR. Detailed electrogram mapping of the CTI was available in all, electroanatomic mapping (EAM) in 8 of 14 (57%) patients. In all, entrainment mapping during tachycardia proved reentry, and showed that the anteroinferior CTI was out of the circuit and the septal CTI was in the circuit in 12 of 14 patients, whereas in 2, the circuit was confined within the mid and/or anteroinferior CTI. Fractionated potentials (FPs) spanning 34-71% of the tachycardia cycle length were recorded within the CTI in all, and double potentials were inscribed in 10 of 14 (71%). Analysis of the tricuspid annulus electrograms showed spontaneous shifts from a counterclockwise (CCW) to clockwise or fusion patterns. Surface ECGs showed either typical CCW pattern (12 patients) or atypical patterns (3 patients). The EAMs showed a focal pattern in 3, a CCW pattern in 5. The successful ablation site always occurred at the area with maximal FP duration. Over the same period, 33 of 384 (9%) patients who underwent ablation for CTI-dependent flutter had prior successful CTI ablation, 7 of 33 (21%) were found to have IIR during the redo procedure.
CONCLUSIONS: (1) Electrogram and ECG patterns of IIR frequently show atypical flutter. (2) IIR was successfully ablated in an area of the CTI associated with maximal duration of FPs. (3) IIR is a significant cause of "recurrent flutter" in patients with prior CTI ablation.
Authors:
Yanfei Yang; Niraj Varma; Nitish Badhwar; Ronn E Tanel; Sirisha Sundara; Randall J Lee; Byron K Lee; Zian H Tseng; Gregory M Marcus; Albert M Kim; Jeffrey E Olgin; Melvin M Scheinman
Related Documents :
2268794 - Incidence and clinical significance of st segment depression in supraventricular tachyc...
11279424 - Epicardial pacemaker implantation and follow-up in patients with a single ventricle aft...
16329014 - Effects of capsule endoscopy on cardiac pacemakers.
495404 - Complications with retained transvenous pacemaker electrodes.
19804514 - Assessment of physiological amplitude, duration, and magnitude of ecg t-wave alternans.
7186504 - Consonant identification in quiet and in noise with the normal and the sensorineural he...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  21     ISSN:  1540-8167     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-11-02     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1099-106     Citation Subset:  IM    
Copyright Information:
© 2010 Wiley Periodicals, Inc.
Affiliation:
University of California-San Francisco, San Francisco, California 94143-1354, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Comments/Corrections
Comment In:
J Cardiovasc Electrophysiol. 2010 Oct;21(10):1107-8   [PMID:  20550609 ]

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


Previous Document:  Gender differences in the clinical characteristics and atrioventricular nodal conduction properties ...
Next Document:  Safety of remote magnetic navigation in patients with pacemakers and implanted cardioverter defibril...