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Cavotricuspid isthmus is constantly a zone of slow conduction: Data from ultra‐high‐resolution mapping
Author(s) -
Bun SokSithikun,
Lațcu Decebal Gabriel,
Wedn Ahmed Mostfa,
Squara Fabien,
Scarlatti Didier,
Theodore Guillaume,
Al Amoura Alaa,
Benaïch Fatima Azzahrae,
Hasni Karim,
Saoudi Nadir,
Ferrari Emile
Publication year - 2020
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/pace.13862
Subject(s) - medicine , atrial flutter , coronary sinus , ablation , cardiology , nerve conduction velocity , nuclear medicine
Background Whether cavotricuspid isthmus (CTI) is a region of conduction slowing during typical flutter has been discussed with conflicting results in the literature. We aimed to evaluate conduction velocity (CV) along the different portions of the typical flutter circuit with a recently proposed method by means of ultra‐high‐resolution (UHR) mapping. Methods Consecutive patients referred for typical atrial flutter (AFL) ablation underwent UHR mapping (Rhythmia, Boston Scientific). CVs were measured in the CTI as well as laterally and septally, respectively, from its lateral and septal borders. Results A total of 33 patients (mean age: 65 ± 13 years; right atrial volume: 134 ± 57 mL) were mapped either during ongoing counterclockwise ( n = 25), or clockwise ( n = 3) AFL (mean cycle length: 264 ± 38 ms), or during coronary sinus pacing at 400 ms ( n = 1), 500 ms ( n = 1), or 600 ms ( n = 3). A total of 13 671 ± 7264 electrograms were acquired in 14 ± 9 min. CTI CV was significantly lower (0.56 ± 0.18 m/s) in comparison with the lateral CV (1.31 ± 0.29 m/s; P < .0001) and the septal border CV of the CTI (1.29 ± 0.31 m/s; P < .0001). Conclusion UHR mapping confirmed that CTI CV was systematically twice lower than atrial conduction velocities outside the CTI.