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

doi:10.1016/j.hrthm.2009.02.019

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

Research output: Contribution to journal › Article

15 Citations (Scopus)

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 language	English
Pages (from-to)	592-598
Number of pages	7
Journal	Heart Rhythm
Volume	6
Issue number	5
DOIs	https://doi.org/10.1016/j.hrthm.2009.02.019
Publication status	Published - May 2009

Keywords

Ablation
Atrial fibrillation
Atrial flutter
Electrogram
Voltage

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Physiology (medical)

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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

Role of the right atrial substrate in different types of atrial arrhythmias. / Lin, Yenn Jiang; Higa, Satoshi; Tai, Ching Tai; Chang, Shih Lin; Lee, Kun Tai; Lo, Li Wei; Ishigaki, Sugako; Tuan, Ta Chuan; Wongcharoen, Wanwarang; Hu, Yu Feng; Hsieh, Min Hsiung; Tsao, Hsuan Ming; Chen, Shih Ann.

In: Heart Rhythm, Vol. 6, No. 5, 05.2009, p. 592-598.

Research output: Contribution to journal › Article

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title = "Role of the right atrial substrate in different types of atrial arrhythmias",

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 ",

keywords = "Ablation, Atrial fibrillation, Atrial flutter, Electrogram, Voltage",

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

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AU - Lin, Yenn Jiang

AU - Higa, Satoshi

AU - Tai, Ching Tai

AU - Chang, Shih Lin

AU - Lee, Kun Tai

AU - Lo, Li Wei

AU - Ishigaki, Sugako

AU - Tuan, Ta Chuan

AU - Wongcharoen, Wanwarang

AU - Hu, Yu Feng

AU - Hsieh, Min Hsiung

AU - Tsao, Hsuan Ming

AU - Chen, Shih Ann

PY - 2009/5

Y1 - 2009/5

N2 - 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

AB - 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

KW - Ablation

KW - Atrial fibrillation

KW - Atrial flutter

KW - Electrogram

KW - Voltage

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