Electroanatomic Analysis of Sinus Impulse Propagation in Normal Human Atria

  title={Electroanatomic Analysis of Sinus Impulse Propagation in Normal Human Atria},
  author={Roberto De Ponti and Siew Yen Ho and Jorge Antonio Salerno-Uriarte and Massimo Tritto and Giammario Spadacini},
  journal={Journal of Cardiovascular Electrophysiology},
Sinus Impulse Propagation in Normal Human Atria. Introduction: Better understanding of atrial propagation during sinus rhythm (SR) in normal hearts under the most normal physiologic conditions may be propaedeutic to pathophysiologic studies of complex atrial arrhythmias. In this study, qualitative and quantitative analyses of sinus impulse propagation in both atria were performed by electroanatomic mapping in patients with no organic heart disease who were undergoing an electrophysiologic… 

Electroanatomic Analysis of Sinus Impulse Propagation in Normal Human Atria

Two patterns of sinus node activation are described as a spindle-shaped activation over the superior portion of the crista terminalis and a U-shaped orientation with an anterior projection in the region of the right atrial (RA) appendage.

P Wave and the Substrates of Arrhythmias Originating in the Atria.

Normal Atrial Activation and Voltage During Sinus Rhythm in the Human Heart: An Endocardial and Epicardial Mapping Study in Patients with a History of Atrial Fibrillation

The sequence of endocardial and epicardial activation and voltage of the atria during normal sinus rhythm is evaluated to evaluate the three‐dimensional contributions to human atrial activation in sinus Rhythm.

Atrial Activation Mapping in Sinus Rhythm in the Clinical Electrophysiology Laboratory:

Introduction: The high posterolateral right atrium (RA) is considered the “sinus node area,” but we lack information on endocardial atrial activation in sinus rhythm. We studied RA and left atrial

Human Study of Biatrial Electrical Coupling: Determinants of Endocardial Septal Activation and Conduction Over Interatrial Connections

Electrical coupling of the RA and LA in humans is predominantly provided by muscular connections at the level of Bachmann's bundle and the coronary sinus, which is asynchronous and discordant, usually without contralateral conduction during sinus rhythm or atrial pacing.

Three‐Dimensional Mapping of Right Atrial Activation During Sinus Rhythm and Its Relationship to Endocardial Architecture

This study describes global RA endocardial activation patterns using high‐density mapping and compares the results with underlying endocardIAL architecture.



Reentry in a Morphologically Realistic Atrial Model

The purpose of this study was to ascertain the role of specific anatomic structures on reentry induction and maintenance in Morphologically Realistic Atria.

Use of electroanatomic mapping to delineate transseptal atrial conduction in humans.

Three distinct sites of early right atrial activation may be demonstrated during left atrial pacing, in accord with anatomic muscle bundles, which may have relevance for maintenance of atrial flutter or fibrillation.

Demonstration of a widely distributed atrial pacemaker complex in the human heart.

Functional assessment was limited in these initial patient studies, but correspondence with similar observations in extensive previous canine studies supports the concept of a widely distributed atrial pacemaker complex in man.

Computerized activation sequence mapping of the human atrial septum.

Method for Simultaneous Epicardial and Endocardial Mapping of In Vivo Canine Heart: Application to Atrial Conduction Properties and Arrhythmia Mechanisms

Endocardial/Epicardial Mapping of AF: The three‐dimensional structure of the atria may be crucial in arrhythmogenesis and previous in vivo atrial activation mapping studies have been limited to either endocardial or epicardial approaches.

Atrial Macroreentry Involving the Myocardium of the Coronary Sinus: A Unique Mechanism for Atypical Flutter

A patient without structural heart disease who presented with an atrial macroreentrant rhythm is described and ablation of the rhythm was accomplished by a circumferential radiofrequency application within the coronary sinus.

A computer model of normal conduction in the human atria.

A finite volume-based computer model of human atrial activation and current flow is described, incorporating both the left and right atria and the major muscle bundles of the atria, including the crista terminalis, pectinate muscles, limbus of the fossa ovalis, and Bachmann's bundle.

Simultaneous Epicardial and Endocardial Activation Sequence Mapping in the Isolated Canine Right Atrium

The findings of this study demonstrate that epicardial and endocardial activation can be discordant in specific regions and that discordance increases with abnormal activation sequences.

Spread of excitation from the atrium into thoracic veins in human beings and dogs.