We have located links that may give you full text access.
High-resolution mapping of the triangle of Koch: Spatial heterogeneity of fast pathway atrionodal connections.
BACKGROUND: Dedicated mapping studies of the triangle of Koch to characterize retrograde fast pathway activation have not been previously performed using high-resolution, 3-dimensional, multielectrode mapping technology.
OBJECTIVE: To delineate the activation pattern and spatial distribution of the retrograde fast pathway within the triangle of Koch during typical atrioventricular nodal reentrant tachycardia (AVNRT) and right ventricular pacing in a consecutive series of patients using the Rhythmia mapping system (Boston Scientific, Natick, MA).
METHODS: A total of 18 patients with symptomatic typical AVNRT referred for ablation underwent ultra high-density mapping of atrial activation with minielectrode basket configuration during tachycardia. The earliest atrial activation was mapped using automated annotation, with manual overreading by 2 independent observers. The triangle of Koch was classified into 3 anatomic regions: anteroseptal (His), midseptal, and posteroseptal (coronary sinus roof). Thirteen patients underwent mapping of atrial activation during ventricular pacing.
RESULTS: A median of 422 mapping points (interquartile range 258-896 points) was acquired within the triangle of Koch during tachycardia. The most common site of earliest atrial activation within the triangle of Koch was anterior in 67% of patients (n = 12). Midseptal early atrial activation was seen in 17% (n = 3), and posteroseptal activation was observed in 11% (n = 2). One patient exhibited broad simultaneous activation of the entire triangle of Koch. Slow pathway potentials were not identified.
CONCLUSIONS: With high-resolution multielectrode mapping, atrial activation during typical AVNRT exhibited anatomic variability and spatially heterogeneous activation within the triangle of Koch. These findings highlight the limitations of an anatomically based classification of atrioventricular nodal retrograde pathways.
OBJECTIVE: To delineate the activation pattern and spatial distribution of the retrograde fast pathway within the triangle of Koch during typical atrioventricular nodal reentrant tachycardia (AVNRT) and right ventricular pacing in a consecutive series of patients using the Rhythmia mapping system (Boston Scientific, Natick, MA).
METHODS: A total of 18 patients with symptomatic typical AVNRT referred for ablation underwent ultra high-density mapping of atrial activation with minielectrode basket configuration during tachycardia. The earliest atrial activation was mapped using automated annotation, with manual overreading by 2 independent observers. The triangle of Koch was classified into 3 anatomic regions: anteroseptal (His), midseptal, and posteroseptal (coronary sinus roof). Thirteen patients underwent mapping of atrial activation during ventricular pacing.
RESULTS: A median of 422 mapping points (interquartile range 258-896 points) was acquired within the triangle of Koch during tachycardia. The most common site of earliest atrial activation within the triangle of Koch was anterior in 67% of patients (n = 12). Midseptal early atrial activation was seen in 17% (n = 3), and posteroseptal activation was observed in 11% (n = 2). One patient exhibited broad simultaneous activation of the entire triangle of Koch. Slow pathway potentials were not identified.
CONCLUSIONS: With high-resolution multielectrode mapping, atrial activation during typical AVNRT exhibited anatomic variability and spatially heterogeneous activation within the triangle of Koch. These findings highlight the limitations of an anatomically based classification of atrioventricular nodal retrograde pathways.
Full text links
Related Resources
Trending Papers
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Prevention and treatment of ischaemic and haemorrhagic stroke in people with diabetes mellitus: a focus on glucose control and comorbidities.Diabetologia 2024 April 17
British Society for Rheumatology guideline on management of adult and juvenile onset Sjögren disease.Rheumatology 2024 April 17
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Albumin: a comprehensive review and practical guideline for clinical use.European Journal of Clinical Pharmacology 2024 April 13
Eosinophilic Esophagitis: Clinical Pearls for Primary Care Providers and Gastroenterologists.Mayo Clinic Proceedings 2024 April
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app