+ Translate

Upper turnaround point of the reentry circuit of common atrial flutter--three-dimensional mapping and entrainment study

, : Upper turnaround point of the reentry circuit of common atrial flutter--three-dimensional mapping and entrainment study. Journal of Interventional Cardiac Electrophysiology 29(3): 147-156

Although the anterior and posterior boundaries of cavotricuspid isthmus-dependent atrial flutter (AFL) are reported to be located at the tricuspid annulus and sinus venosa region or crista terminalis, the exact upper turnaround point of the AFL circuit remains unclear. The aim of this study was to determine the upper turnaround site of the AFL circuit by means of three-dimensional (3D) mapping and entrainment pacing. Subjects were 21 patients with counter-clockwise AFL in whom high-density mapping of the high right atrium (RA) and superior vena cava (SVC) orifice was performed with an electroanatomical or non-contact mapping system. Entrainment pacing was performed around the SVC-RA junction. In 20 of the 21 patients, the wavefront from the septal RA split into two wavefronts: one that traveled anterior to the SVC and another that traveled to the posterior RA where it was blocked. In the remaining patient, the wavefront from the septal RA split into two wavefronts: one that propagated through the anterior portion of the SVC orifice and another that propagated transversely across the posterior portion of the SVC orifice. The two wavefronts joined in the lateral RA. Entrainment pacing from the SVC-RA junction demonstrated that the anterior boundary was within the circuit in all patients, but the posterior boundary also constituted a circuit in four patients. We surmise that the upper turnaround site of the AFL circuit is located in the anterior portion of the SVC-RA junction in the majority of patients with AFL.

(PDF same-day service: $19.90)

Accession: 056780213

PMID: 21107670

DOI: 10.1007/s10840-010-9526-0

Submit PDF Full Text: Here

Submit PDF Full Text

No spam - Every submission is manually reviewed

Due to poor quality, we do not accept files from Researchgate

Submitted PDF Full Texts will always be free for everyone
(We only charge for PDFs that we need to acquire)

Select a PDF file:

Related references

Fujiki, A.; Nishida, K.; Sakabe, M.; Sugao, M.; Tsuneda, T.; Mizumaki, K.; Inoue, H., 2004: Entrainment mapping of dual-loop macroreentry in common atrial flutter: new insights into the atrial flutter circuit. Introduction: The aim of this study was to determine using entrainment mapping whether the reentrant circuit of common type atrial flutter (AFL) is single loop or dual loop. Methods and Results: In 12 consecutive patients with counterclockwise (CC...

Tsuchiya, T.; Okumura, K.; Tabuchi, T.; Iwasa, A.; Yasue, H.; Yamabe, H., 1996: The upper turnover site in the reentry circuit of common atrial flutter. The upper turnover site of the reentry circuit of common atrial flutter was examined with the uses of atrial activation mapping and extrastimulus techniques during atrial flutter. The findings suggest that it is anterior to the orifice of the supe...

Maury, P.; Duparc, A.; Hebrard, A.; E.B.yomy, M.; Delay, M., 2008: Prevalence of typical atrial flutter with reentry circuit posterior to the superior vena cava: use of entrainment at the atrial roof. Upper turn-around of the reentry circuit in typical atrial flutter (AF) is classically described to be located in front of the superior vena cava (SVC), but circuits posterior to the SVC as well as lower loop reentry (LLR) involving only the lower...

Arribas, F.; López-Gil, M.; Cosío, F.G.; Núñez, A., 1998: The upper link of human common atrial flutter circuit: definition by multiple endocardial recordings during entrainment. Common atrial flutter is due to a macroreentry circuit in the right atrium, but the cranial path of the circuit has not been defined. The objectives of this article are to determine the cranial turning point of flutter activation in relation to a...

Hansen, P.S.; Ouyang, F.; Baensch, D.; Volkmer, M.; Krings, G.; Ernst, S.; Zhuang, S.; Cappato, R.; Hebe, J.; Kuck, K.H.inz, 1999: Combined high-density electroanatomical and entrainment mapping of common-type human atrial flutter with respect to the tachycardia circuit. Circulation 100(18 SUPPL ): I 499-I 500, Nov 2

Shah, D.C.; Jaïs, P.; Haïssaguerre, M.; Chouairi, S.; Takahashi, A.; Hocini, M.; Garrigue, S.; Clémenty, J., 1997: Three-dimensional mapping of the common atrial flutter circuit in the right atrium. Background. The full circuit of common atrial flutter using conventional methods of sequential or multielectrode activation mapping is not completely understood. Methods and Results. We performed three-dimensional right atrial endocardial activati...

Tanoiri T.; Komatsu C.; Ishinaga T.; Tokushia Y.; Makino H.; Nomoto J.; Mogi J.; Okamura T., 1991: Study on the genesis of the double potential recorded in the high right atrium in atrial flutter and its role in the reentry circuit of atrial flutter. To investigate the genesis of the double potential (DP), which is two separate waves, and its role in the reentry circuit of atrial flutter (AF), we performed overdrive pacing (ODP) from the high right atrium (HRA) in six cases of spontaneous AF i...

Disertori, M.; Inama, G.; Vergara, G.; Guarnerio, M.; Del Favero, A.; Furlanello, F., 1983: Evidence of a reentry circuit in the common type of atrial flutter in man. To investigate the mechanism of atrial flutter (AF) in humans, we studied 13 patients during episodes of spontaneous common AF, with simultaneous multiple atrial endocavitary recordings and atrial programmed stimulation. In all patients, low paras...

Yamabe, H.; Yamamuro, M.; Yoshida, T.; Morikami, Y.; Kimura, Y.; Hokamura, Y., 2002: Demonstration of the exact anatomical tachycardia circuit of the typical atrial flutter using entrainment mapping. Journal of the American College of Cardiology 39(5 Supplement A): 115A, March 6

Schmitt, C.; Ndrepepa, G.; Zrenner, B., 2001: Reentry circuit location and left atrial three-dimensional activation patterns in left atrial flutter. We report the case of a patient with left atrial flutter (LAF) in whom the reentry circuit location was mapped with a 64-electrode basket catheter deployed in the left atrium. Left atrial three-dimensional activation patterns were constructed with...