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The Anatomic Relationship of the Esophageal Lead to the Left Atrium
Author(s) -
BINKLEY PHILIP F.,
BUSH CHARLES A.,
KOLIBASH ALBERT J.,
MAGORIEN RAYMOND D.,
HAMLIN ROBERT L.,
LEIER CARL V.
Publication year - 1982
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1982.tb06567.x
Subject(s) - medicine , interatrial septum , left atrium , cardiology , catheter , esophagus , atrium (architecture) , p wave , left pulmonary vein , atrial fibrillation , anatomy , radiology
This study was undertaken to establish the “in vivo” anatomic relationship of the esophageal catheter to the left atrium. Fourteen patients, seven of whom had enlarged left atria, were included in the study. During cardiac calheterization, a bipolar recording catheter was placed in ihe esophagus; left atrial cineangiograms were then obtained in the posterior‐anterior (PA), left anterior oblique (LAO), and lateral views. The distance of the esophageal catheter, in each of four commonly used positions, to the interatrial septum‐right atrium was measured in the PA and LAO cineangiograms. The distance from the same catheter positions to the posterior left atrial wall was measured from the lateral view. In all positions and regardless of left atrial size, the catheter clearly lay behind the left atrium and was closer (0 the left atrial wall than any other cardiac structure, including the interatrial septum. Bipolar electrograms were recorded from the four commonly used esophageal locations; afrial wave amplitude and other parameters of the electrogram deflection did not vary significantly in ihe different lead positions. We conclude that esophageal electrograms reflect left atrial activity by virtue of the recording electrode's clear proximity to this structure. The amplitude and configuration of the atriai wave itself is generally not useful in determining the position of the esophageal lead.