Fragmented electrograms and continuous electrical activity in atrial flutter

Cosío, Francisco G.; Arribas, Fernando; Palacios, J.M.; Tascón, Juan; López‐Gil, María

doi:10.1016/0002-9149(86)90210-9

Cited by 119 publications

(36 citation statements)

References 19 publications

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“…The general pattern of RA activation during typical CCW AFL is circular, going up the atrial septum and down the RA anterior wall 14 and in studies using the entrainment mapping technique the CT and the Eustachian ridge were the anterior barrier of the reentrant circuit. 5,6 The broad band of peritricuspid activation narrows as it enters the cavotricuspid isthmus, slows in the medial portion, ascends the septum and crosses the roof in front of the SVC or, more rarely fusing around it.…”

Section: Global Electroanatomic Mapping During Typical Ccw Aflmentioning

confidence: 99%

Activation Patterns and Conduction Velocity in Posterolateral Right Atrium During Typical Atrial Flutter Using an Electroanatomic Mapping System

Sawa

Shimizu

Ueyama

et al. 2008

Circ J

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Background To investigate the activation patterns and conduction velocity (CV) in the posterolateral right atrial (RA) wall during typical counterclockwise atrial flutter (AFL) using an electroanatomic mapping system. Methods and Results During typical AFL in 25 patients, the transverse conduction pattern and CV were classified and calculated. The line blocking transverse conduction was defined by the conduction pattern and double potentials recorded during mapping. There were 3 types (including 2 subtypes) of transverse conduction pattern based on the conduction blocks across the posterolateral RA in a line between the superior and inferior venae cava. Trans-cristal conduction activation in a horizontal direction was seen in all but 4 patients. The CV in the gap area was 0.59±0.21 m/s. Conclusions Three types of transverse conduction pattern were observed during trans-ctristal conduction and the trans-ctristal CV was relatively slower than that in other parts of the RA, except for the isthmus. (Circ J 2008; 72: 384 -391)

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Section: Global Electroanatomic Mapping During Typical Ccw Aflmentioning

confidence: 99%

Activation Patterns and Conduction Velocity in Posterolateral Right Atrium During Typical Atrial Flutter Using an Electroanatomic Mapping System

Sawa

Shimizu

Ueyama

et al. 2008

Circ J

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“…For the septal and posterior walls, the mean bipolar electrogram voltage was significantly lower in the AFL group than in the PAF group. Taken together, these findings suggest that an increased fragmentation and fibrosis (Cosio et al 1986) as identified by the reduction in the electrogram voltage in the RA septum and posterior wall, may contribute to the electrophysiological properties responsible for the slow conduction in patients with AFL.…”

Section: Voltage Map In the Right Atriummentioning

confidence: 72%

“…Therefore, the atrial septum has a musculature with a complicated arrangement of the atrial fibers. In the diseased atrium, a nonuniform arrangement of the atrial fibers and increased fragmentation and fibrosis (Cosio et al 1986) might lead to anisotrophy and a slow conduction velocity. Therefore, the atrial fibers might be activated asynchronously, which could cause the lower voltage of the septal wall (Spach and Dollber 1986;Lin et al 2005).…”

Section: Mechanism Of the Electrophysiological Properties In The Righmentioning

confidence: 99%

Electrophysiological Properties of the Right Atrial Septum in Patients with Atrial Tachyarrhythmias

Yamada

Kumagai

Fukuda

et al. 2008

Tohoku J. Exp. Med.

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Common-type atrial flutter (AFL) is a type of atrial tachyarrhythmia with counterclockwise rotation around the tricuspid annulus within the right atrium (RA). It was recently reported that the electrogram voltage reduction observed in the RA was involved in the development of AFL. However, the relationship between the low voltage areas and conduction velocity during AFL has not been fully described. In this study, patients with AFL (n = 17) and without AFL (n = 4) were examined using an electro-anatomical mapping system. The patients with AFL were divided into 2 groups; AFL group (n = 8) and coronary sinus ostium (CSO) group (n = 9). The AFL group was defined as exhibiting the maintenance of AFL and the CSO group sinus rhythm before the catheter ablation. The electrogram voltages of each area in the RA (septum, and posterior and lateral walls), conduction velocity during AFL and transverse and longitudinal conduction velocities were evaluated. In the septum, the mean electrogram voltage was significantly lower in the AFL and CSO groups than in the group without AFL. Moreover, the conduction velocity during AFL was significantly slower in the septum, and both the septal transverse and longitudinal conduction velocities were significantly slower in the AFL and CSO groups than in the group without AFL. In conclusion, these findings suggest that both the slower conduction velocities and lower voltage in the RA septum may be involved in the development of AFL. Thus, ablation of the RA septum may represent a therapeutic approach of AFL. atrial flutter; atrial septum; catheter ablation; conduction velocity; bipolar voltage. Tohoku

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“…[4][5][6] In almost all patients, endocardial mapping during tachycardia allows recording of lowvoltage prolonged and fragmented potentials in the low posterior right atrial septum, which is the suspected critical slow conduction area of the reentrant circuit. 4,6,7) This phenomenon led to an attempt at direct current ablation of the low posterior right atrial septum by Chauvin et al 8) in 1989 and Saoudi et al in 1990. 9) O'Núnáin et al 10) reported the effectiveness of low-energy direct current shocks to the triangle of Koch in 7 cases in 1992.…”

mentioning

confidence: 99%

Electro‐Anatomical Characteristics of Typical Atrial Flutter

Watanabe

2010

Journal of Arrhythmia

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Type 1 atrial flutter (AFL) is a macroreentrant tachycardia in the right atrium; the anterior barrier of the common AFL circuit is located at the tricuspid annulus (TA) and the posterior border is functional line of block at the posteromedial (sinus venosa region) right atrium. The upper turnover site of the wave front is mainly located at the anterior to the superior vena cava. Conduction property across the posteromedial (sinus venosa region) right atrium in patients with and without AFL is different. i.e., functional conduction block occurs at the lower pacing rate in patients with AFL, and the majority of patients with chronic AFL demonstrate conduction block across the posteromedial (sinus venosa region) right atrium even during sinus rhythm. Catheter ablation therapy for AFL is creation of linear lesion between tricuspid annulus and inferior vena cava. Changes in activation sequence around the tricuspid annulus are used to confirm bidirectional block. However, it is difficult to demonstrate the bidirectional block in the presence of transverse conduction around the inferior vena cava. In such a case, bidirectional block should be confirmed by differential pacing or 3-dimensional mapping system. (J Arrhythmia 2010; 26: 157-169)

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Fragmented electrograms and continuous electrical activity in atrial flutter

Cited by 119 publications

References 19 publications

Activation Patterns and Conduction Velocity in Posterolateral Right Atrium During Typical Atrial Flutter Using an Electroanatomic Mapping System

Activation Patterns and Conduction Velocity in Posterolateral Right Atrium During Typical Atrial Flutter Using an Electroanatomic Mapping System

Electrophysiological Properties of the Right Atrial Septum in Patients with Atrial Tachyarrhythmias

Electro‐Anatomical Characteristics of Typical Atrial Flutter

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