Role of the right atrial substrate in different types of atrial arrhythmias
Background: The regional distribution of the low-voltage zones (LVZs) may relate to the maintenance of atrial arrhythmias in the right atrium (RA). Objectives: The purpose of this study was to investigate the RA substrate characteristics in different types of atrial arrhythmias originating from RA a...
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th-cmuir.6653943832-598472018-09-10T03:22:24Z Role of the right atrial substrate in different types of atrial arrhythmias Yenn Jiang Lin Satoshi Higa Ching Tai Tai Shih Lin Chang Kun Tai Lee Li Wei Lo Sugako Ishigaki Ta Chuan Tuan Wanwarang Wongcharoen Yu Feng Hu Min Hsiung Hsieh Hsuan Ming Tsao Shih Ann Chen Medicine Background: The regional distribution of the low-voltage zones (LVZs) may relate to the maintenance of atrial arrhythmias in the right atrium (RA). Objectives: The purpose of this study was to investigate the RA substrate characteristics in different types of atrial arrhythmias originating from RA and left atrium (LA). Methods: Forty-five patients (35 men, age = 62 ± 15 years) with RA atypical atrial flutter (n = 15, group 1), RA atrial fibrillation (AF; n = 15, no PV initiating foci, group 2), and LA AF (n = 1 5, no RA arrhythmias, group 3) referred for three-dimensional EnSite mapping were included. Voltage and activation maps were visualized. Results: The mean voltage of the RA was lower in group 2, and compared with group 3, a voltage reduction during atrial pacing was evident in groups 1 and 2. The fixed LVZs (independent of the rhythm) were mostly located along the lower crista terminalis (CT). A functional extension of the LVZ was located on the CT in 84% of patients, sinus venosa in 18%, and free-wall region in 27%, forming the borders of the slow conduction isthmus for the reentrant circuits. The number of slow conduction isthmuses was 1.3 ± 0.9, 2.2 ± 1.0, and 0.87 ± 0.74, for the groups 1-3 patients, respectively (P <.05). Radiofrequency ablation connecting the LVZs successfully eliminated those isthmuses. The long-term follow-up revealed that 66% of the patients remained in sinus rhythm. Conclusions: Single and multiple slow conduction isthmuses bordered by the fixed and functional LVZs were critical for the reentrant circuits in the RA. The conduction isthmuses could be identified by their substrate characteristics and ablated successfully. © 2009 Heart Rhythm Society. 2018-09-10T03:22:24Z 2018-09-10T03:22:24Z 2009-05-01 Journal 15475271 2-s2.0-64649099112 10.1016/j.hrthm.2009.02.019 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=64649099112&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/59847 |
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Medicine Yenn Jiang Lin Satoshi Higa Ching Tai Tai Shih Lin Chang Kun Tai Lee Li Wei Lo Sugako Ishigaki Ta Chuan Tuan Wanwarang Wongcharoen Yu Feng Hu Min Hsiung Hsieh Hsuan Ming Tsao Shih Ann Chen Role of the right atrial substrate in different types of atrial arrhythmias |
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Background: The regional distribution of the low-voltage zones (LVZs) may relate to the maintenance of atrial arrhythmias in the right atrium (RA). Objectives: The purpose of this study was to investigate the RA substrate characteristics in different types of atrial arrhythmias originating from RA and left atrium (LA). Methods: Forty-five patients (35 men, age = 62 ± 15 years) with RA atypical atrial flutter (n = 15, group 1), RA atrial fibrillation (AF; n = 15, no PV initiating foci, group 2), and LA AF (n = 1 5, no RA arrhythmias, group 3) referred for three-dimensional EnSite mapping were included. Voltage and activation maps were visualized. Results: The mean voltage of the RA was lower in group 2, and compared with group 3, a voltage reduction during atrial pacing was evident in groups 1 and 2. The fixed LVZs (independent of the rhythm) were mostly located along the lower crista terminalis (CT). A functional extension of the LVZ was located on the CT in 84% of patients, sinus venosa in 18%, and free-wall region in 27%, forming the borders of the slow conduction isthmus for the reentrant circuits. The number of slow conduction isthmuses was 1.3 ± 0.9, 2.2 ± 1.0, and 0.87 ± 0.74, for the groups 1-3 patients, respectively (P <.05). Radiofrequency ablation connecting the LVZs successfully eliminated those isthmuses. The long-term follow-up revealed that 66% of the patients remained in sinus rhythm. Conclusions: Single and multiple slow conduction isthmuses bordered by the fixed and functional LVZs were critical for the reentrant circuits in the RA. The conduction isthmuses could be identified by their substrate characteristics and ablated successfully. © 2009 Heart Rhythm Society. |
format |
Journal |
author |
Yenn Jiang Lin Satoshi Higa Ching Tai Tai Shih Lin Chang Kun Tai Lee Li Wei Lo Sugako Ishigaki Ta Chuan Tuan Wanwarang Wongcharoen Yu Feng Hu Min Hsiung Hsieh Hsuan Ming Tsao Shih Ann Chen |
author_facet |
Yenn Jiang Lin Satoshi Higa Ching Tai Tai Shih Lin Chang Kun Tai Lee Li Wei Lo Sugako Ishigaki Ta Chuan Tuan Wanwarang Wongcharoen Yu Feng Hu Min Hsiung Hsieh Hsuan Ming Tsao Shih Ann Chen |
author_sort |
Yenn Jiang Lin |
title |
Role of the right atrial substrate in different types of atrial arrhythmias |
title_short |
Role of the right atrial substrate in different types of atrial arrhythmias |
title_full |
Role of the right atrial substrate in different types of atrial arrhythmias |
title_fullStr |
Role of the right atrial substrate in different types of atrial arrhythmias |
title_full_unstemmed |
Role of the right atrial substrate in different types of atrial arrhythmias |
title_sort |
role of the right atrial substrate in different types of atrial arrhythmias |
publishDate |
2018 |
url |
https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=64649099112&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/59847 |
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1681425327060942848 |