Focal atrial tachycardia arising from the tricuspid annulus: Electrophysiologic and electrocardiographic characteristics

Morton, Joseph B.; Das, Asim Bikas; Vohra, Jitu; Kálmán, J.

doi:10.1046/j.1443-9506.2000.08400.x

Cited by 33 publications

(51 citation statements)

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“…The cavo-tricuspid isthmus is the area where radiofrequency ablation is used in the treatment of atrial flutter and fibrillation [15][16][17][18][19][20][21][22][23][24][25]; during the procedure, pacing of the coronary sinus and the right atrium is performed. During certain cardiosurgical procedures, cardioplegia is performed by retrograde perfusion of the myocardium through the coronary sinus [26,27).…”

Section: Discussionmentioning

confidence: 99%

Anatomical peculiarities of the cavo-tricuspid isthmus in the human heart

Pejković

Krajnc²

2006

Wien Klin Wochenschr

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The cavo-tricuspid isthmus is the term for the part of the right atrium between the ostium of the inferior vena cava and its border--the Eustachian ridge on one side and the tricuspid valve on the other side. In this area lie the coronary sinus ostium with its Thebesian valve, the fibers of Chiari (10%), and ostia of the deep cardiac veins--the Thebesian veins in close relation to the coronary sinus ostium (35%). Pacing of the coronary sinus is very often used during the treatment of cardiac arrhythmias; radiofrequency catheter ablation in cases of permanent atrial tachycardia is successfully performed through the coronary sinus; during certain cardiosurgical procedures, cardioplegia is performed by retrograde perfusion of the myocardium through the coronary sinus. Knowing and recognizing certain anatomical peculiarities of the structures in this part of the right atrium may be interesting for clinical practice.

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Section: Discussionmentioning

confidence: 99%

Anatomical peculiarities of the cavo-tricuspid isthmus in the human heart

Pejković

Krajnc²

2006

Wien Klin Wochenschr

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“…In the RA, a negative P wave in lead aVR suggests a right lateral location, specifically the crista terminalis with 100% sensitivity and 93% specificity, while negative P waves in leads V 5 and V 6 suggest an inferomedial location [30]. AT arising from the non-septal tricuspid annulus had a preference for the inferoanterior region with negative P waves in precordial leads, positive in aVL and negative in lead III [17]. AT arising from the apex of the triangle of Koch (para-Hisian AT) usually demonstrates narrow P waves in AT as compared to sinus rhythm with biphasic P wave in V 1 and early precordial transition [14] (Figure 32.2).…”

Section: Electrocardiographic Characteristicsmentioning

confidence: 97%

“…Less frequently, they can arise from the coronary sinus (CS) musculature [12], the CS ostium [13], the para-Hisian region [14], the appendages [15,16], interatrial septum, tricuspid annulus [17], mitral annulus [18] and the aortic cusps [19].…”

Section: Introductionmentioning

confidence: 99%

Mapping of Focal Right Atrial and Coronary Sinus Tachycardias

et al. 2012

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Focal atrial tachycardias (ATs) usually arise from well-defined anatomical regions in the right and the left atrium. The mechanisms include automaticity, triggered activity and microreentry. While the common presentation is paroxysmal supraventricular tachycardia (SVT), it can present as incessant tachycardia leading to cardiomyopathy. Distinctive P-wave morphology on a 12-lead electrocardiogram (ECG) can help localize the site of origin of focal AT. Atrial tachycardia is often resistant to medical therapy; hence catheter ablation offers a suitable alternative. Recent advances in three-dimensional mapping and navigation systems have contributed significantly to the improved success of catheter ablation of AT.

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“…Past studies have reported that in the right atrium (RA), foci tend to occur along the crista terminalis [1], around the tricuspid annulus [2], and in the para-hisian region [3] and in the left atrium (LA), foci tend to occur around the mitral annlus [5] and pulmonary vein [6]. But only limited studies describing the focal AT arising from the cavotricuspid isthmus was available [7].…”

Section: Major Findingsmentioning

confidence: 99%

“…In the right atrium (RA), foci tend to occur along the crista terminalis [1], around the tricuspid annulus [2], and in the para-hisian region [3]. However, there is little information about focal AT arising from cavotricuspid isthmus (CTI).…”

Section: Introductionmentioning

confidence: 99%