Characterization of Right Atrial Substrate in Patients with Supraventricular Tachyarrhythmias

Lin, Yenn‐Jiang; Tai, Ching‐Tai; Huang, Jin‐Long; Lee, Kun-Tai; Lee, Pi-Chang; Hsieh, Ming‐Hsiung; Lee, Shih‐Huang; Higa, Satoshi; Yuniadi, Yoga; Liu, Tu-Ying; Chen, Shih‐Ann

doi:10.1046/j.1540-8167.2005.40513.x

Cited by 58 publications

(72 citation statements)

References 30 publications

(34 reference statements)

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“…A previous study reported that the electrogram voltage distribution in the right atrium was functionally dependent on the cycle lengths (Lin et al 2005). However, in the present study, a low voltage in the septum in the patients with AFL could be found in comparison to those without AFL even during pacing at a cycle length of 600 msec from the CSO after creating conduction block in the isthmus between the IVC and TA, which might indicate the electrophysiological properties of the RA septum.…”

Section: Mechanism Of the Electrophysiological Properties In The Righcontrasting

confidence: 71%

“…However, there has been some controversy as to the exact location of the area of slow conduction within the AFL circuit. Furthermore, the mean unipolar electrogram voltage of the global RA using a noncontact mapping system is significantly decreased during AFL as compared with sinus rhythm and this reduction has been noted in the lower septum as well as the CT and isthmus between the IVC and TA (Lin et al 2005). Therefore, the relationship between the low voltage areas and conduction velocity in the AFL circuits has not yet been described.…”

Section: Study Populationmentioning

confidence: 99%

“…However, even in patients with AFL without any structural heart disease, but not in those with atrial tachycardia with a focal origin or atrioventricular nodal reentrant tachycardia, the reduction in the bipolar and unipolar electrogram voltage was identified using the electro-anatomic system (de Groot et al 2003). A recent study using a non-contact mapping system also demonstrated that the electrogram voltage was reduced in the RA septum as well as in the CT and isthmus between the IVC and TA during atrial pacing and AFL (Lin et al 2005).…”

Section: Voltage Map In the Right Atriummentioning

confidence: 99%

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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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Section: Mechanism Of the Electrophysiological Properties In The Righcontrasting

confidence: 71%

Section: Study Populationmentioning

confidence: 99%

Section: Voltage Map In the Right Atriummentioning

confidence: 99%

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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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“…24,25) The voltage reduction primarily originated from the ablative tissue injury and also the change in the activation rhythm. 12) In this study, we sampled the electrogram voltage along the ablation line. The results demonstrated that a greater reduction in the voltage was observed at the mid CTI ablation.…”

Section: Electrogram Voltage Reduction After Radiofrequency Ablationmentioning

confidence: 99%

“…9,10) Recently, a non-contact mapping (NCM) system has helped to determine the three-dimensional location of the ablation lesion accurately and reconstructs local virtual unipolar electrograms. 11,12) Therefore, a comparison of the local electrograms at the same sites is possible and can be used to evaluate the effect of acute ablative atrial tissue injury and to detect complete CTI block by the local electrogram voltage and the morphologic characteristics. Therefore, the purpose of this study was to investigate the voltage and the characteristics of the local virtual unipolar electrograms after radiofrequency ablation (RFA) of the CTI in patients with typical AFL using non-contact mapping system.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Virtual Unipolar Electrogram Voltage and Characteristics of Isthmus Block during Radiofrequency Ablation of Typical Atrial Flutter

Takahashi

Watanabe

Kofune

et al. 2015

Nichidai Igaku Zasshi

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Background:The optimal technique for recording of the electrogram to detect complete cavo-tricuspid isthmus (CTI) block during radiofrequency ablation (RFA) of the typical atrial flutter (AFL) using non-contact mapping system remains unclear. The aim of this study was to investigate the characteristics of the local virtual unipolar electrogram recorded at the ablation line during coronary sinus pacing after RFA of the CTI.Methods: Non-contact mapping was performed in 8 patients with AFL. Non-contact virtual unipolar electrograms were obtained before and after CTI linear ablation. All unipolar electrograms were acquired with both wide-band (0.5-300 Hz and 0.5-IC 150 Hz) and narrow-band filtering (32-300 Hz). The unipolar electrogram measurements included both the peak-to-peak voltage and peak-negative voltage for both filter settings, and the morpho logical characteristics of the second component of double potentials.Results: Comparison of the electrogram voltage along the ablation line before and after ablation demonstrated: 1) peak-negative voltage reduction at the mid-portion of the ablation line by 0.5-IC 150 Hz filtering, and 2) the second component of unipolar electrogram morphologies of R, Rs or rSR were the most sensitive and specific recording technique to predict conduction block.Conclusions: Non-contact unipolar electrograms using the peak-negative voltage with 0.5-IC 150 Hz and a predominant R-wave pattern in the second component at the ablation line indicate complete CTI block, even in the presence of transcristal conduction.

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Mapping of the Atrial Electrogram in Sinus Rhythm and Different Atrial Fibrillation Substrates

Lin

Chang

et al. 2012

Cardiac Mapping

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Characterization of Right Atrial Substrate in Patients with Supraventricular Tachyarrhythmias

Abstract: Negative unipolar voltage analysis of global RA showed different RA substrate characteristics during various SVT. The substrate property of activation and cycle length-dependent voltage reduction may be related to the development of AFL and AF.

Cited by 58 publications

References 30 publications

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

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

Characteristics of Virtual Unipolar Electrogram Voltage and Characteristics of Isthmus Block during Radiofrequency Ablation of Typical Atrial Flutter

Mapping of the Atrial Electrogram in Sinus Rhythm and Different Atrial Fibrillation Substrates

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