1988
DOI: 10.1161/01.cir.77.6.1221
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Demonstration of a widely distributed atrial pacemaker complex in the human heart.

Abstract: Atrial depolarization was analyzed in 14 patients with the Wolff-Parkinson-White syndrome undergoing surgery to ablate accessory atrioventricular pathways associated with tachyarrhythmias. Bipolar potentials were recorded simultaneously from 156 atrial epicardial electrodes arranged in three templates to fit the anterior and posterior aspects of both atria. Spontaneous or sinus rhythms were recorded, as were atrial escape rhythms after overdrive pacing at rates of 150 and 200 beats/min. Atrial activation maps … Show more

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Cited by 275 publications
(220 citation statements)
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“…The leading pacemaker site can, however, move spontaneously along the terminal crest of the right atrium, a phenomenon known as the wandering pacemaker. In open heart surgery, patients and in healthy individuals, the leading pacemaker site has been shown to be located anywhere along the terminal crest between the openings of the superior and inferior caval veins (Boineau et al, 1988;Ramanathan et al, 2004;Ramanathan et al, 2006). Such findings are in agreement with studies on smaller mammals.…”
Section: Introductionsupporting
confidence: 84%
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“…The leading pacemaker site can, however, move spontaneously along the terminal crest of the right atrium, a phenomenon known as the wandering pacemaker. In open heart surgery, patients and in healthy individuals, the leading pacemaker site has been shown to be located anywhere along the terminal crest between the openings of the superior and inferior caval veins (Boineau et al, 1988;Ramanathan et al, 2004;Ramanathan et al, 2006). Such findings are in agreement with studies on smaller mammals.…”
Section: Introductionsupporting
confidence: 84%
“…The angles of the primary eigenvectors are incorporated into the 3D anatomical model and are available in the Supporting Information. Figure 8A shows the leading pacemaker site (red area) and the activation sequence of the atria of a patient (from Boineau et al, 1988). In this patient, the leading pacemaker site was at the junction of the superior caval vein with the right atrium.…”
Section: Myocyte Orientationmentioning
confidence: 99%
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“…Variability of the location of sinus rhythm origin including its extreme anterior locations has been reported earlier by Boineau et al 26 …”
Section: P Wave Morphologysupporting
confidence: 55%