Conduction Properties of the Crista Terminalis in Patients with Atrial Flutter Due to Amiodarone Therapy for Atrial Fibrillation

Ching Tai Tai, Yung Kuo Lin, Fei Chiun Lan, Hung Yi Chen, Yu An Ding, Mau Song Chang, Shih Ann Chen

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3 Citations (Scopus)

Abstract

Some patients with atrial fibrillation (AF) treated by antiarrhythmic drugs (AAD) can develop typical atrial flutter, but the mechanism is not clear. This study included 21 patients with AF. Group I (n = 7) had typical atrial flutter due to amiodarone therapy. Group II (n = 7) did not develop atrial flutter after amiodarone treatment. Group III (n = 7) did not receive AAD treatment. A 7 Fr, 20-pole electrode catheter was placed along the CT identified by fluoroscopy and intracardiac echocardiography. After restoration of the sinus rhythm, decremental pacing near the CT was performed until 2 to 1 atrial capture. Complete transverse conduction block was defined as the appearance of double potentials with opposite activation sequence along the CT. Focal transverse conduction delay was defined as the appearance of double potentials at ≥ 2 recording sites. Focal transverse conduction delay was observed during pacing at the cycle length of 693 ± 110 ms in group I, 360 ± 97 ms in group II and 343 ± 109 ms in group III (P = 0.001). Complete transverse conduction block was observed during pacing at the cycle length of 391 ± 118 ms in group I and 231 ± 23 ms in group II (P = 0.001), but not in group III. In conclusion, focal transverse conduction delay in the CT was common in patients with AF. A predisposition to the line of the conduction block in the CT might contribute to the conversion of AF to typical atrial flutter due to amiodarone therapy.

Original languageEnglish
Pages (from-to)2241-2246
Number of pages6
JournalPACE - Pacing and Clinical Electrophysiology
Volume26
Issue number12
DOIs
Publication statusPublished - Dec 2003
Externally publishedYes

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Keywords

  • Amiodarone
  • Atrial fibrillation
  • Atrial flutter
  • Crista terminalis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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