Interatrial conduction block and retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmia

Luna, Antoni Bayés de; Cladellas, Mercè; Oter, R.; Torner, P.; Guindo, Josep; Martı́, Vicens; Rivera, I Chávez; Iturralde, Pedro

doi:10.1093/oxfordjournals.eurheartj.a062407

Cited by 269 publications

(181 citation statements)

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“…In particular, 38% of ARVC patients had atypical P waves not meeting predefined morphology criteria with activation vector directed posteriorly in the sagittal plane (Atypical or Type 4) that appeared as positive P waves in lead Z. One ARVC patient had a P wave that met criteria for advanced interatrial block with retrograde activation of the left atrium, 18,19 i.e. biphasic P wave morphology in inferior leads and P wave duration >120 ms (Type 3).…”

Section: Psa-ecg Analysismentioning

confidence: 99%

Abnormal atrial activation is common in patients with arrhythmogenic right ventricular cardiomyopathy

Platonov¹,

Christensen²,

Holmqvist³

et al. 2011

Journal of Electrocardiology

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Section: Psa-ecg Analysismentioning

confidence: 99%

Abnormal atrial activation is common in patients with arrhythmogenic right ventricular cardiomyopathy

Platonov¹,

Christensen²,

Holmqvist³

et al. 2011

Journal of Electrocardiology

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“…As the atrial arrhythmia is a substan tial compound of sinus node disease, the first and most important finding of our study is that the implantation of an atrial electrode and pacing of the Bachmann's bundle area results in upholding or nearly restoring a physiological atrial activation pattern in comparison to the right atrial append age placement. Prolongation of the Pwave dura tion was related to a higher risk of atrial fibrillation episodes and a risk of atrial fibrillation in a postop erative period [6][7][8]. The duration of the Pwave (lasting more than 120 ms) concomitantly with typical morphology in the inferior ECG leads (bi phasic (+/-) or notched (+/+)), was an indicator of interatrial conduction disturbances and a greater risk of atrial arrhythmia in a few studies [6,9,10].…”

Section: Discussionmentioning

confidence: 96%

Bachmann’s Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing

Sławuta

Kliś²,

Skoczyński

et al. 2016

Adv Clin Exp Med

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in a surface electrocardiogram. A slower inter atrial conduction takes place in the coronary si nus. The physiological left atrial contraction de lay amounts to 22 ± 11 ms in relation to the right atrium [1][2][3].The interatrial conduction disorders are rela tively common in sick sinus syndrome patients, which contribute to atrial arrhythmias, in par The implantation of a permanent pacemaker alters the electrophysiological and hemodynam ic relations in a heart. The electrical physiologi cal activation of the atria comes from the sino atrial node. The left atrium activation is achieved throughout the conductive tissue layer called the Objectives. This study was aimed to assess the influence of the atrial pacing site on interatrial and atrioventricular conduction as well as the percentage of ventricular pacing in patients with sick sinus syndrome implanted with atrioventricular pacemaker. Material and Methods. The study population: 96 patients (58 females, 38 males) aged 74.1 ± 11.8 years were divided in two groups: Group 1 (n = 44) with right atrial appendage pacing and group 2 (n = 52) with Bachmann's area pacing. We assessed the differences in atrioventricular conduction in sinus rhythm and atrial 60 and 90 bpm pacing, Pwave duration and percentage of ventricular pacing. Results. No differences in baseline Pwave duration in sinus rhythm between the groups (102.4 ± 17 ms vs. 104.1 ± 26 ms, p = ns.) were noted. Atrial pacing 60 bpm resulted in longer Pwave in group 1 vs. group 2 (138.3 ± 21 vs. 106.1 ± 15 ms, p < 0.01). The differences between atrioventricular conduction time during sinus rhythm and atrial pacing at 60 and 90 bpm were significantly longer in patients with right atrial appendage vs. Bachmann's pacing (44.1 ± 17 vs. 9.2 ± 7 ms p < 0.01 and 69.2 ± 31 vs. 21.4 ± 12 ms p < 0.05, respectively). The percentage of ventricular pacing was higher in group 1 (21 vs. 4%, p < 0.01). Conclusions. Bachmann's bundle pacing decreases interatrial and atrioventricular conduction delay. Moreover, the frequencydependent atrioventricular conduction lengthening is much less pronounced during Bachmann's bundle pacing. Right atrial appendage pacing in sick sinus syndrome patients promotes a higher percentage of ventricular pacing (Adv Clin Exp Med 2016, 25, 5, 845-850).

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“…127,128 An ECG pattern of interatrial (Bachmann) block is often associated with atypical flutter/MRT based in the LA. 129,130 This ECG pattern may be associated too with inexcitable, low-voltage areas in the LA (see Figure 10). …”

Section: Left Atrial Macro-re-entrant Tachycardiasmentioning

confidence: 99%

Atrial Flutter, Typical and Atypical: A Review

Cosío

2017

Arrhythmia &Amp; Electrophysiology Review

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Clinical electrophysiology has made the traditional classification of rapid atrial rhythms into flutter and tachycardia of little clinical use. Electrophysiological studies have defined multiple mechanisms of tachycardia, both re-entrant and focal, with varying ECG morphologies and rates, authenticated by the results of catheter ablation of the focal triggers or critical isthmuses of re-entry circuits. In patients without a history of heart disease, cardiac surgery or catheter ablation, typical flutter ECG remains predictive of a right atrial re-entry circuit dependent on the inferior vena cava–tricuspid isthmus that can be very effectively treated by ablation, although late incidence of atrial fibrillation remains a problem. Secondary prevention, based on the treatment of associated atrial fibrillation risk factors, is emerging as a therapeutic option. In patients subjected to cardiac surgery or catheter ablation for the treatment of atrial fibrillation or showing atypical ECG patterns, macro-re-entrant and focal tachycardia mechanisms can be very complex and electrophysiological studies are necessary to guide ablation treatment in poorly tolerated cases.

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Interatrial conduction block and retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmia

Cited by 269 publications

References 0 publications

Abnormal atrial activation is common in patients with arrhythmogenic right ventricular cardiomyopathy

Abnormal atrial activation is common in patients with arrhythmogenic right ventricular cardiomyopathy

Bachmann’s Bundle Pacing not Only Improves Interatrial Conduction but Also Reduces the Need for Ventricular Pacing

Atrial Flutter, Typical and Atypical: A Review

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