This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Boyden, P. A. Articles by Hoffman, B. F. Search for Related Content PubMed PubMed Citation Articles by Boyden, P. A. Articles by Hoffman, B. F.

Circulation, Vol 79, 406-416, Copyright © 1989 by American Heart Association

ARTICLES

Activation mapping of reentry around an anatomic barrier in the canine atrium. Observations during entrainment and termination

PA Boyden, LH Frame and BF Hoffman
Department of Pharmacology, College of Physicians and Surgeons, Columbia University, New York, NY 10032.

We determined total right atrial activation sequences during entrainment and termination of flutter induced in dogs with a surgically induced atrial lesion. This type of atrial flutter is due to circus movement of an impulse around the tricuspid valve orifice. We recorded simultaneously from 96 bipolar intracavity electrodes in the right atrium of the isolated, perfused heart. By constructing isochronal maps, we demonstrated the pattern of atrial activation during atrial pacing protocols that either entrained or entrained and then terminated the reentrant rhythm. We show that during pacing the antidromic wavefront from the paced impulse (An) collides with the orthodromic wavefront from the previous paced impulse (On-1). During entrainment, the site of collision of the orthodromic and antidromic wavefronts was constant during pacing at a fixed rate but shifted in the antidromic direction as the pacing rate increased. Furthermore, the last paced beat was entrained only up to the site of collision of the previous paced beat. During one period of entrainment, termination of the reentrant arrhythmia occurred because On-1 blocked in the reentrant pathway due to refractory tissue left by On-2. However, subsequent An did not collide directly with On as was expected, but rather On blocked by an interaction with tissue left refractory by An. Because On was blocked, no reentry occurred when pacing ended.

This article has been cited by other articles:

				G. L. Stump, A. A. Wallace, C. P. Regan, and J. J. Lynch Jr. In Vivo Antiarrhythmic and Cardiac Electrophysiologic Effects of a Novel Diphenylphosphine Oxide IKur Blocker (2-Isopropyl-5-methylcyclohexyl) Diphenylphosphine Oxide J. Pharmacol. Exp. Ther., December 1, 2005; 315(3): 1362 - 1367. [Abstract] [Full Text] [PDF]

				D. K. Racker The AV junction region of the heart: a comprehensive study correlating gross anatomy and direct three-dimensional analysis. Part II. Morphology and cytoarchitecture Am J Physiol Heart Circ Physiol, May 1, 2004; 286(5): H1853 - H1871. [Abstract] [Full Text] [PDF]

				A. G. KLEBER and Y. RUDY Basic Mechanisms of Cardiac Impulse Propagation and Associated Arrhythmias Physiol Rev, April 1, 2004; 84(2): 431 - 488. [Abstract] [Full Text] [PDF]

				J. B. Morton, M. J. Byrne, J. M. Power, J. Raman, and J. M. Kalman Electrical Remodeling of the Atrium in an Anatomic Model of Atrial Flutter: Relationship Between Substrate and Triggers for Conversion to Atrial Fibrillation Circulation, January 15, 2002; 105(2): 258 - 264. [Abstract] [Full Text] [PDF]

				Y. Iesaka, T. Yamane, M. Goya, A. Takahashi, H. Fujiwara, Y. Okamoto, Y. Soejima, J. Nitta, A. Nogami, K. Aonuma, et al. A jump in cycle length of orthodromic common atrial flutter during catheter ablation at the isthmus between the inferior vena cava and tricuspid annulus: Evidence of dual isthmus conduction directed to dual septal exits Europace, January 1, 2000; 2(2): 163 - 171. [Abstract] [PDF]

				B. Schumacher, W. Jung, H. Schmidt, C. Fischenbeck, T. Lewalter, A. Hagendorff, H. Omran, C. Wolpert, and B. Luderitz Transverse conduction capabilities of the crista terminalis in patients with atrial flutter and atrial fibrillation J. Am. Coll. Cardiol., August 1, 1999; 34(2): 363 - 373. [Abstract] [Full Text] [PDF]

				E. Robert, A. G. M. Aya, J. E. de la Coussaye, P. Peray, J.-M. Juan, J. Brugada, J.-M. Davy, and J.-J. Eledjam Dispersion-based reentry: mechanism of initiation of ventricular tachycardia in isolated rabbit hearts Am J Physiol Heart Circ Physiol, February 1, 1999; 276(2): H413 - H423. [Abstract] [Full Text] [PDF]

				S. B. Fishberger, G. Wernovsky, T. L. Gentles, K. Gauvreau, J. Burnett, J. E. Mayer Jr., and E. P. Walsh FACTORS THAT INFLUENCE THE DEVELOPMENT OF ATRIAL FLUTTER AFTER THE FONTAN OPERATION J. Thorac. Cardiovasc. Surg., January 1, 1997; 113(1): 80 - 86. [Abstract] [Full Text]

				J. M. Kalman, J. E. Olgin, L. A. Saxon, W. G. Fisher, R. J. Lee, and M. D. Lesh Activation and Entrainment Mapping Defines the Tricuspid Annulus as the Anterior Barrier in Typical Atrial Flutter Circulation, August 1, 1996; 94(3): 398 - 406. [Abstract] [Full Text]

				J. E. Olgin, J. M. Kalman, A. P. Fitzpatrick, and M. D. Lesh Role of Right Atrial Endocardial Structures as Barriers to Conduction During Human Type I Atrial Flutter : Activation and Entrainment Mapping Guided by Intracardiac Echocardiography Circulation, October 1, 1995; 92(7): 1839 - 1848. [Abstract] [Full Text]

				F. Philippon, V. J. Plumb, A. E. Epstein, and G. N. Kay The Risk of Atrial Fibrillation Following Radiofrequency Catheter Ablation of Atrial Flutter Circulation, August 1, 1995; 92(3): 430 - 435. [Abstract] [Full Text]