RELATION BETWEEN TRANSVERSE CONDUCTIONCAPABILITY AND THE ANATOMY OF THE CRISTATERMINALIS IN PATIENTS WITH AND WITHOUT ATRIALFLUTTER

摘要

The aim of this study was to assess transverse conduction capabilities, refractoriness and location of conduction block and the anatomy of crista terminalis (CT) in patients with and without atrial flutter (AFL). Sequential 2-dimensional ICE images were obtained from superior vena cava (SVC) to inferior vena cava (IVC) in 12 patients with typical AFL and 15 patients without AFL. Live ultrasound acquisitions were reconstructed into 3D representation of the RA. To determine transverse conduction capability of CT, a 20 polar catheter was positioned along the CT. During extrastimuli from coronary sinus ostium and lower lateral right atrium, refractory period (RP) of the CT was defined as the longest coupling interval that resulted in a transverse block. Results: The site of transverse conduction block was located 12.0+-3.8mm inside the CT in all patients. In patients with AFL, 3D morphology of the CT showed greater, but in patients without AFL CT became smaller. RP of the transverse blocking site was longer in patients with AFL than without AFL, and site-specific difference was noted. Conclusions: In patients with AFL, RP of the CT was longer and the greater CT was seen. However, the actual functional blocking site is located in more septal site.