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(Circulation. 1999;100:e31-e37.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

Living Anatomy of the Atrioventricular Junctions. A Guide to Electrophysiologic Mapping

A Consensus Statement from the Cardiac Nomenclature Study Group, Working Group of Arrhythmias, European Society of Cardiology, and the Task Force on Cardiac Nomenclature from NASPE

Francisco G. Cosío, MD; Robert H. Anderson, MD; Karl-Heinz Kuck, MD; Anton Becker, MD; Martin Borggrefe, MD; Ronald W. F. Campbell, MD¹; Fiorenzo Gaita, MD; Gerard M. Guiraudon, MD; Michel Haïssaguerre, MD; Juan J. Rufilanchas, MD; Gaetano Thiene, MD; Hein J. J. Wellens, MD; Jonathan Langberg, MD; David G. Benditt, MD; Saroja Bharati, MD; George Klein, MD; Francis Marchlinski, MD; Sanjeev Saksena, MD

From the Cardiac Nomenclature Study Group Working Group of Arrhythmias, European Society of Cardiology (F.G.C., R.H.A., A.B., M.B., F.G., G.M.G., M.H., K.-H.K., J.J.R., G.T., H.J.J.W.) and the Nomenclature Expert Panel, North American Society of Pacing and Electrophysiology (J.L., D.G.B., S.B., W.J., G.K., F.M., S.S.)

Correspondence to Francisco G. Cosío, MD, Chief Cardiology Service, Hospital Universitario de Getafe, Carretera de Toledo, km 12,5, 28905 Getafe, Madrid.

Abstract—Current nomenclature for the atrioventricular (AV) junctions derives from a surgically distorted view, placing the valvar rings and the triangle of Koch in a single plane with antero-posterior and right-left lateral coordinates. Within this convention, the aorta is considered to occupy an anterior position, although the mouth of the coronary sinus is shown as being posterior. Although this nomenclature has served its purpose for the description and treatment of arrhythmias dependent on accessory pathways and atrioventricular nodal reentry, it is less than satisfactory for the description of atrial and ventricular mapping. To correct these deficiencies, a consensus document has been prepared by experts from the Working Group of Arrhythmias of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. It proposes a new anatomically sound nomenclature that will be applicable to all chambers of the heart. In this report, we discuss its value for description of the AV junctions, establishing the principles of this new nomenclature.

Key Words: anatomic nomenclature • atrioventricular junctions • triangle of Koch • atrial mapping • accessory pathway ablation

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