| Prospective observations in the clinical and electrophysiological characteristics of intra-isthmus reentry. | |
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MedLine Citation:
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PMID: 20455984 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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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. |
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Authors:
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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 |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of cardiovascular electrophysiology Volume: 21 ISSN: 1540-8167 ISO Abbreviation: J. Cardiovasc. Electrophysiol. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-11-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9010756 Medline TA: J Cardiovasc Electrophysiol Country: United States |
Other Details:
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Languages: eng Pagination: 1099-106 Citation Subset: IM |
Copyright Information:
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© 2010 Wiley Periodicals, Inc. |
Affiliation:
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University of California-San Francisco, San Francisco, California 94143-1354, USA. |
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Comment In:
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J Cardiovasc Electrophysiol. 2010 Oct;21(10):1107-8
[PMID:
20550609
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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