This Article Full Text 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 Man, K. C. Articles by Morady, F. Search for Related Content PubMed PubMed Citation Articles by Man, K. C. Articles by Morady, F.

(Circulation. 1996;94:1357-1363.)
© 1996 American Heart Association, Inc.

Articles

Spatial Resolution of Atrial Pace Mapping as Determined by Unipolar Atrial Pacing at Adjacent Sites

K. Ching Man, DO; K.K. Chan, MD; Paul Kovack, DO; Rajiva Goyal, MD; Frank Bogun, MD; Mark Harvey, MD; Emile Daoud, MD; S. Adam Strickberger, MD; Fred Morady, MD

the Division of Cardiology, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor.

Background The purpose of this study was to examine the spatial resolution of unipolar atrial pace mapping by pacing at adjacent sites within the coronary sinus and the right atrium.

Methods and Results Unipolar pacing from each pole of a quadripolar catheter was performed in the coronary sinus (n=29) and in the right atrium (n=10). Pacing from the distal electrode was used to simulate the site of origin of an atrial tachycardia. These P waves were compared with the P waves generated by unipolar pacing from each of the three proximal electrodes. The P waves were analyzed for changes in amplitude, duration, and configuration. Pacing within the coronary sinus resulted in significant changes in amplitude and duration at distances of 17 and 21 mm from the distal pole, respectively. Similarly, pacing in the right atrium resulted in significant changes in amplitude and duration at distances of 17 and 32 mm from the distal pole, respectively. No significant changes in configuration were noted in the coronary sinus in any lead at pacing sites 32 mm from the distal pole. Configurational changes were noted in the right atrium at pacing sites 17 mm from the distal pole.

Conclusions The spatial resolution of unipolar atrial pace mapping is 17 mm. These findings indicate that mapping techniques that depend on the accurate discrimination of P-wave morphology, such as pace mapping or concealed entrainment, are likely to be imprecise when used in the atria.

Key Words: tachycardia • mapping • pacing

This article has been cited by other articles:

				P. M. Kistler, K. C. Roberts-Thomson, H. M. Haqqani, S. P. Fynn, S. Singarayar, J. K. Vohra, J. B. Morton, P. B. Sparks, and J. M. Kalman P-Wave Morphology in Focal Atrial Tachycardia: Development of an Algorithm to Predict the Anatomic Site of Origin J. Am. Coll. Cardiol., September 5, 2006; 48(5): 1010 - 1017. [Abstract] [Full Text] [PDF]

				P. M. Kistler, P. Sanders, S. P. Fynn, I. H. Stevenson, A. Hussin, J. K. Vohra, P. B. Sparks, and J. M. Kalman Electrophysiological and Electrocardiographic Characteristics of Focal Atrial Tachycardia Originating From the Pulmonary Veins: Acute and Long-Term Outcomes of Radiofrequency Ablation Circulation, October 21, 2003; 108(16): 1968 - 1975. [Abstract] [Full Text] [PDF]

				T. Yamane, D. C. Shah, J.-T. Peng, P. Jais, M.e. Hocini, I. Deisenhofer, K.-J. Choi, L. Macle, J. Clementy, and M. Haissaguerre Morphological characteristics of P waves during selective pulmonary vein pacing J. Am. Coll. Cardiol., November 1, 2001; 38(5): 1505 - 1510. [Abstract] [Full Text] [PDF]

				K. C. Man, B. Knight, H.-F. Tse, F. Pelosi, G. F. Michaud, M. Flemming, S. A. Strickberger, and F. Morady Radiofrequency catheter ablation of inappropriate sinus tachycardia guided by activation mapping J. Am. Coll. Cardiol., February 1, 2000; 35(2): 451 - 457. [Abstract] [Full Text] [PDF]

				A. SippensGroenewegen, H. A. P. Peeters, E. R. Jessurun, A. C. Linnenbank, E. O. Robles de Medina, M. D. Lesh, and N. M. van Hemel Body Surface Mapping During Pacing at Multiple Sites in the Human Atrium : P-Wave Morphology of Ectopic Right Atrial Activation Circulation, February 3, 1998; 97(4): 369 - 380. [Abstract] [Full Text] [PDF]