ISSN 2149-2263 | E-ISSN 2149-2271
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Novel method to evaluate the conduction velocity and conducting area during isthmus-dependent atrial flutter [Anatol J Cardiol]
Anatol J Cardiol. 2011; 11(8): 711-716 | DOI: 10.5152/akd.2011.193

Novel method to evaluate the conduction velocity and conducting area during isthmus-dependent atrial flutter

Hitoshi Ishida1, Kazuo Matsumoto1, Masahiro Uenishi1, Motoki Hara1, Nobuyuki Komiyama1, Ritsushi Kato1, Shigeyuki Nishimura1, Takeshi Tobiume1, Yurika Ishizuka1, Zekeriya Küçükdurmaz2, Alim Erdem3, Ebru Gölcük4
1Department of Cardiology, International Medical Center, Saitama Medical University, Hidaka/Saitama-Japan
2Department of Cardiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas
3Department of Cardiology, Faculty of Medicine, Abant İzzet Baysal University, Bolu-Turkey
4Department of Cardiology, Istanbul Medical Faculty, Istanbul University, İstanbul

Objective: The difference of the conduction velocity (CV) around the tricuspid valve annulus between the counter-clockwise (CCW) atrial flutter and the clockwise (CW) atrial flutter has not been well clarified. This study was undertaken to evaluate the CV and the conducting area (CA) per millisecond around the tricuspid valve annulus using the electroanatomical mapping. Methods: The electroanatomical mapping was performed during the tachycardia for 30 consecutive patients (mean age: 61±16 years) with isthmus-dependent atrial flutter (CCW, 25; CW, 5). We measured the CV and the CA of five divided areas of the right atrium, that is, upper septum (US), lower septum (LS), isthmus (I), upper lateral wall (UL) and lower lateral wall (LL) using the novel measurement method in the isochronal map. Statistical differences of these data between the two groups were assessed by the Student’s t-test and one-way analysis of variance methods. Results: In total, the CV of the LS was significantly slower than other areas (m/sec: US, 0.57±0.18; LS, 0.43±0.18; UL, 0.60±0.26; LL, 0.53±0.20; I, 0.50±0.17; p<0.05) and the CA of the US and UL were significantly larger than other areas (mm2/sec: US, 34.5±16.2; LS, 16.2±9.5; UL, 40.0±14.1; LL, 27.0±17.0; I, 16.8±8.5; p<0.0001). There was no significant difference between the CCW and the CW atrial flutters in terms of the CV and the CA of equally divided five areas. Conclusion: In both of the CCW and the CW atrial flutters, the CV of the LS was significantly slower than other areas and the CA of the lower atrium was significantly smaller than the upper atrium.

Keywords: Atrial flutter, conduction velocity, conducting area, electroanatomical mapping system

Hitoshi Ishida, Kazuo Matsumoto, Masahiro Uenishi, Motoki Hara, Nobuyuki Komiyama, Ritsushi Kato, Shigeyuki Nishimura, Takeshi Tobiume, Yurika Ishizuka, Zekeriya Küçükdurmaz, Alim Erdem, Ebru Gölcük. Novel method to evaluate the conduction velocity and conducting area during isthmus-dependent atrial flutter. Anatol J Cardiol. 2011; 11(8): 711-716
Manuscript Language: English


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