AI Article Synopsis
- The study investigates the activation sequence of typical atrial flutter (AFL) in the right atrium, focusing on the lesser-known areas beyond the tricuspid annulus.
- Researchers used intracardiac echocardiography (ICE) and mapping techniques to analyze conduction blocks during AFL in 21 patients.
- Findings reveal that the conduction block occurs at the septal edge of the crista terminalis or in the posteroseptal right atrium, rather than directly at the crista terminalis itself.
Article Abstract
Introduction: The activation sequence in typical atrial flutter (AFL) around the tricuspid annulus is well described. However, activation of the remainder of the right atrium (RA) is not well defined. Previous studies have shown a linear block at the crista terminalis (CT) during AFL. The aim of this study was to evaluate the relationship between the location of the CT and the line of block by intracardiac echocardiography (ICE).
Methods And Results: Twenty-one patients with typical AFL were included in the study. The ICE imaging catheter (9-French with 9-MHz ultrasound transducer) was advanced to the RA. Under ICE guidance, a 20-pole roving catheter was used to map double potentials (DPs) during AFL, and three-dimensional images of the RA were reconstructed. During counterclockwise (CCW), clockwise (CW) AFL, or both, a line of conduction block manifested by DPs was identified at a septal site adjacent to the CT in 12 patients and in the posteroseptal RA in 9 patients.
Conclusion: The functional line of block in CCW and CW AFL is localized not at the CT but at the septal edge of the CT or in the posteroseptal RA.
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| http://dx.doi.org/10.1046/j.1540-8167.2004.04379.x | DOI Listing |
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