Role of the right atrial substrate in different types of atrial arrhythmias

Yenn Jiang Lin, Satoshi Higa, Ching Tai Tai, Shih Lin Chang, Kun Tai Lee, Li Wei Lo, Sugako Ishigaki, Ta Chuan Tuan, Wanwarang Wongcharoen, Yu Feng Hu, Min Hsiung Hsieh, Hsuan Ming Tsao, Shih Ann Chen

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Abstract

Background: The regional distribution of the low-voltage zones (LVZs) may relate to the maintenance of atrial arrhythmias in the right atrium (RA). Objectives: The purpose of this study was to investigate the RA substrate characteristics in different types of atrial arrhythmias originating from RA and left atrium (LA). Methods: Forty-five patients (35 men, age = 62 ± 15 years) with RA atypical atrial flutter (n = 15, group 1), RA atrial fibrillation (AF; n = 15, no PV initiating foci, group 2), and LA AF (n = 1 5, no RA arrhythmias, group 3) referred for three-dimensional EnSite mapping were included. Voltage and activation maps were visualized. Results: The mean voltage of the RA was lower in group 2, and compared with group 3, a voltage reduction during atrial pacing was evident in groups 1 and 2. The fixed LVZs (independent of the rhythm) were mostly located along the lower crista terminalis (CT). A functional extension of the LVZ was located on the CT in 84% of patients, sinus venosa in 18%, and free-wall region in 27%, forming the borders of the slow conduction isthmus for the reentrant circuits. The number of slow conduction isthmuses was 1.3 ± 0.9, 2.2 ± 1.0, and 0.87 ± 0.74, for the groups 1-3 patients, respectively (P

Original languageEnglish
Pages (from-to)592-598
Number of pages7
JournalHeart Rhythm
Volume6
Issue number5
DOIs
Publication statusPublished - May 2009

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Keywords

  • Ablation
  • Atrial fibrillation
  • Atrial flutter
  • Electrogram
  • Voltage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Lin, Y. J., Higa, S., Tai, C. T., Chang, S. L., Lee, K. T., Lo, L. W., Ishigaki, S., Tuan, T. C., Wongcharoen, W., Hu, Y. F., Hsieh, M. H., Tsao, H. M., & Chen, S. A. (2009). Role of the right atrial substrate in different types of atrial arrhythmias. Heart Rhythm, 6(5), 592-598. https://doi.org/10.1016/j.hrthm.2009.02.019