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Interatrial right-to-left conduction in patients with paroxysmal atrial fibrillation

Tapanainen, Jari M.; Jurkko, Raija; Holmqvist, Fredrik LU ; Husser, Daniela; Kongstad Rasmussen, Ole LU ; Makijarvi, Markku; Toivonen, Lauri and Platonov, Pyotr LU (2009) In Journal of Interventional Cardiac Electrophysiology 25(2). p.117-122
Abstract
We wanted to illustrate the right-to-left impulse propagation routes during sinus in patients with paroxysmal atrial fibrillation (PAF), as alterations in conduction patterns have been linked to the pathogenesis of PAF, and as no large patient materials have been published. Patients underwent 3-D electroanatomical contact mapping prior to catheter ablation. The site of the earliest left atrial (LA) activation was determined. Three different interatrial routes were identified, either as solitary pathways (36/50 patients, 72%) or in their combinations (14/50). Bachmann's bundle (BB) was involved in the majority of the cases with solitary routes (25/36). More seldom, impulse propagation occurred near the oval fossa (FO) (7/36) or the coronary... (More)
We wanted to illustrate the right-to-left impulse propagation routes during sinus in patients with paroxysmal atrial fibrillation (PAF), as alterations in conduction patterns have been linked to the pathogenesis of PAF, and as no large patient materials have been published. Patients underwent 3-D electroanatomical contact mapping prior to catheter ablation. The site of the earliest left atrial (LA) activation was determined. Three different interatrial routes were identified, either as solitary pathways (36/50 patients, 72%) or in their combinations (14/50). Bachmann's bundle (BB) was involved in the majority of the cases with solitary routes (25/36). More seldom, impulse propagation occurred near the oval fossa (FO) (7/36) or the coronary sinus ostium (4/36). In patients with combined routes, both the BB (10/14) and FO routes (11/14) were included in most cases. In PAF patients, LA can be activated during sinus rhythm through three distinct connections, either encompassing a single route or via any combination of these connections. In one third, the earliest LA activation occurs outside BB. The knowledge of the propagation patterns may give insight into the pathophysiology of PAF and into refining ablation therapy. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Catheter ablation, Interatrial conduction, Atrial fibrillation, Electroanatomic mapping, Sinus rhythm
in
Journal of Interventional Cardiac Electrophysiology
volume
25
issue
2
pages
117 - 122
publisher
Springer
external identifiers
  • wos:000267683500006
  • scopus:67651108951
ISSN
1572-8595
DOI
10.1007/s10840-008-9359-2
language
English
LU publication?
yes
id
125ad2c6-8286-47fc-9610-3278ba4ea2be (old id 1463088)
date added to LUP
2009-08-31 11:04:48
date last changed
2017-01-01 05:15:05
@article{125ad2c6-8286-47fc-9610-3278ba4ea2be,
  abstract     = {We wanted to illustrate the right-to-left impulse propagation routes during sinus in patients with paroxysmal atrial fibrillation (PAF), as alterations in conduction patterns have been linked to the pathogenesis of PAF, and as no large patient materials have been published. Patients underwent 3-D electroanatomical contact mapping prior to catheter ablation. The site of the earliest left atrial (LA) activation was determined. Three different interatrial routes were identified, either as solitary pathways (36/50 patients, 72%) or in their combinations (14/50). Bachmann's bundle (BB) was involved in the majority of the cases with solitary routes (25/36). More seldom, impulse propagation occurred near the oval fossa (FO) (7/36) or the coronary sinus ostium (4/36). In patients with combined routes, both the BB (10/14) and FO routes (11/14) were included in most cases. In PAF patients, LA can be activated during sinus rhythm through three distinct connections, either encompassing a single route or via any combination of these connections. In one third, the earliest LA activation occurs outside BB. The knowledge of the propagation patterns may give insight into the pathophysiology of PAF and into refining ablation therapy.},
  author       = {Tapanainen, Jari M. and Jurkko, Raija and Holmqvist, Fredrik and Husser, Daniela and Kongstad Rasmussen, Ole and Makijarvi, Markku and Toivonen, Lauri and Platonov, Pyotr},
  issn         = {1572-8595},
  keyword      = {Catheter ablation,Interatrial conduction,Atrial fibrillation,Electroanatomic mapping,Sinus rhythm},
  language     = {eng},
  number       = {2},
  pages        = {117--122},
  publisher    = {Springer},
  series       = {Journal of Interventional Cardiac Electrophysiology},
  title        = {Interatrial right-to-left conduction in patients with paroxysmal atrial fibrillation},
  url          = {http://dx.doi.org/10.1007/s10840-008-9359-2},
  volume       = {25},
  year         = {2009},
}