The University of Southampton
University of Southampton Institutional Repository

Characteristics of right atrial activation during coronary sinus pacing

Characteristics of right atrial activation during coronary sinus pacing
Characteristics of right atrial activation during coronary sinus pacing
Introduction: Anatomic and electrical connections between the left atrium and right atrium (RA) have been described. The relationship between coronary sinus (CS) pacing site and RA activation has not been examined.
Methods and Results: Fifteen anesthetized swine underwent high-density noncontact mapping of the RA during pacing from up to five different sites within the CS. Isopotential mapping identified the site of earliest RA depolarization and the pattern of subsequent activation. Hearts were excised and endocardial dissection performed. Earliest RA activation occurred at the CS os with proximal CS pacing sites and at Bachmann's bundle at distal pacing sites. The mean depth at which a shift in earliest RA activation site occurred was 46 ± 13 mm (range 21 to 63 mm). RA activation times following earliest activation at the CS and Bachmann's bundle were 40 ± 4 msec and 51 ± 6 msec (P < 0.002). Conduction delay or block was recorded at the lateral cavotricuspid isthmus, terminal crest, and tendon of Todaro. Latest RA activation always occurred in the high anterolateral atrium after ascending the anterolateral wall. The lateral RA was activated by the wavefront that traversed the posterior wall rather than by the wavefront crossing the cavotricuspid isthmus, even with earliest RA activation at the CS os.
Conclusion: The site of earliest RA activation during CS pacing is dependent upon the pacing depth within the CS. In the porcine heart, areas of conduction delay influence RA activation patterns and timings. These findings may have implications for patients undergoing assessment of radiofrequency ablation of atrial flutter.
1045-3873
794-800
Betts, Tim R.
deac7746-b99a-4316-a312-16a3e43ab0ec
Ho, Siew Yen
2183d00f-cdd7-4c3c-81ac-d10dfe2b5d62
Sanchez-Quintana, Damian
643f4106-126a-499e-bdd3-03c9eb9d4776
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Anderson, Robert H.
0bfb7485-0146-471b-a3b0-ac63678b9778
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680
Betts, Tim R.
deac7746-b99a-4316-a312-16a3e43ab0ec
Ho, Siew Yen
2183d00f-cdd7-4c3c-81ac-d10dfe2b5d62
Sanchez-Quintana, Damian
643f4106-126a-499e-bdd3-03c9eb9d4776
Roberts, Paul R.
193431e8-f9d5-48d6-8f62-ed9052b2571d
Anderson, Robert H.
0bfb7485-0146-471b-a3b0-ac63678b9778
Morgan, John M.
ac98099e-241d-4551-bc98-709f6dfc8680

Betts, Tim R., Ho, Siew Yen, Sanchez-Quintana, Damian, Roberts, Paul R., Anderson, Robert H. and Morgan, John M. (2002) Characteristics of right atrial activation during coronary sinus pacing. Journal of Cardiovascular Electrophysiology, 13 (8), 794-800. (doi:10.1046/j.1540-8167.2002.00794.x).

Record type: Article

Abstract

Introduction: Anatomic and electrical connections between the left atrium and right atrium (RA) have been described. The relationship between coronary sinus (CS) pacing site and RA activation has not been examined.
Methods and Results: Fifteen anesthetized swine underwent high-density noncontact mapping of the RA during pacing from up to five different sites within the CS. Isopotential mapping identified the site of earliest RA depolarization and the pattern of subsequent activation. Hearts were excised and endocardial dissection performed. Earliest RA activation occurred at the CS os with proximal CS pacing sites and at Bachmann's bundle at distal pacing sites. The mean depth at which a shift in earliest RA activation site occurred was 46 ± 13 mm (range 21 to 63 mm). RA activation times following earliest activation at the CS and Bachmann's bundle were 40 ± 4 msec and 51 ± 6 msec (P < 0.002). Conduction delay or block was recorded at the lateral cavotricuspid isthmus, terminal crest, and tendon of Todaro. Latest RA activation always occurred in the high anterolateral atrium after ascending the anterolateral wall. The lateral RA was activated by the wavefront that traversed the posterior wall rather than by the wavefront crossing the cavotricuspid isthmus, even with earliest RA activation at the CS os.
Conclusion: The site of earliest RA activation during CS pacing is dependent upon the pacing depth within the CS. In the porcine heart, areas of conduction delay influence RA activation patterns and timings. These findings may have implications for patients undergoing assessment of radiofrequency ablation of atrial flutter.

Full text not available from this repository.

More information

Published date: 2002

Identifiers

Local EPrints ID: 25255
URI: http://eprints.soton.ac.uk/id/eprint/25255
ISSN: 1045-3873
PURE UUID: cdc3b514-1df8-4a24-aefe-1c5e4afd23b7

Catalogue record

Date deposited: 06 Apr 2006
Last modified: 15 Jul 2019 19:16

Export record

Altmetrics

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×