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

• Published in: Circulation Journal Vol. 72; no. 3; pp. 384 - 391
• Main Authors: Sawa, Akira, Shimizu, Akihiko, Ueyama, Takeshi, Yoshiga, Yasuhiro, Suzuki, Shinsuke, Sugi, Naoki, Oono, Makoto, Oomiya, Toshihide, Matsuzaki, Masunori
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 2008
• Subjects: Aged; Atrial flutter; Atrial Flutter - physiopathology; Catheter ablation; Catheter Ablation - instrumentation; Catheter Ablation - methods; Conduction velocity; Crista terminalis; Electroanatomic mapping system; Electrophysiologic Techniques, Cardiac - instrumentation; Electrophysiologic Techniques, Cardiac - methods; Female; Heart Atria - physiopathology; Heart Conduction System - physiopathology; Heart Rate - physiology; Humans; Male; Middle Aged; Myocardial Contraction - physiology; Vena Cava, Inferior - physiopathology; Vena Cava, Superior - physiopathology
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.72.384

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)