Sinus node exit, crista terminalis conduction, interatrial connection and wavefront collision: key features of human atrial activation in sinus rhythm.

Heart Rhythm ◽  
2022 ◽  
Author(s):  
Thomas Pambrun ◽  
Nicolas Derval ◽  
Josselin Duchateau ◽  
F. Daniel Ramirez ◽  
Rémi Chauvel ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Sinus Node ◽  
Crista Terminalis ◽  
Key Features ◽  
Atrial Activation

Role of sinoatrial ring bundle in internodal conduction

1976 ◽  
Vol 231 (2) ◽  
pp. 319-325 ◽  
Author(s):  
M Hiraoka ◽  
T Sano
Keyword(s):  
Sinus Node ◽  
The Other ◽  
Wave Fronts ◽  
Av Node ◽  
Crista Terminalis ◽  
Main Route ◽  
Endocardial Surface ◽  
The Right ◽  
Activation Sequence

The role of the sinoatrial ring bundle (SARB) in internodal conduction was examined by the microelectrode technique in excised rabbit hearts. The spread of the sinus impluse to the surrounding tissues was shown to proceed anteriorly toward the right branch of the crista terminalis significantly faster than toward the other direction. Thus the right SARB and the right branch of the crista terminalis close to the sinus node were the earliest areas excited by the sinus impulse in the areas surrounding the sinus node. It was further shown that the activation sequence does not initiate from the right SARB to the right branch of the crista terminalis via the junction of these two structures. Cutting the SARB did not produce any delay in conduction from the sinus node to the atrioventricular (AV) node. The conduction velocity measured at the endocardial surface by two microelectrodes has proved that conduction in the crista terminalis was significantly faster than in the SARB. The upstroke of the action potential from the crista terminalis was also steeper than that from the SARB. These results suggest that the SARB is not the main route for impulse propagation from the sinus node to the AV node; the fastest internodal conduction therefore takes place with wide wave fronts, along the crista terminalis.

Relation of canine atrial activation sequence to anatomic landmarks

1982 ◽  
Vol 242 (3) ◽  
pp. H421-H428 ◽  
Author(s):  
H. Hayashi ◽  
R. L. Lux ◽  
R. F. Wyatt ◽  
M. J. Burgess ◽  
J. A. Abildskov
Keyword(s):  
Fiber Direction ◽  
Entry And Exit ◽  
Activation Time ◽  
Anatomic Landmarks ◽  
Crista Terminalis ◽  
Bipolar Electrodes ◽  
First Derivative ◽  
Bachmann’S Bundle ◽  
Atrial Activation ◽  
Activation Sequence

Activation sequence in the atria was investigated in 35 dogs. The atria were studied as four regions, and activation sequence in one region was determined in each experiment. In each region 60 electrograms were recorded simultaneously from bipolar electrodes. The maximal first derivative of the electrograms was taken as activation time. Dried atrial specimens, which permitted identification of pectinate muscles, crista terminalis, and the axis of fiber direction, were prepared. Nonuniform activation was demonstrated with more rapid conduction over the long axis of fiber direction and in Bachmann's bundle, crista terminalis, and pectinate muscles. These regions of rapid conduction were the same during sinus rhythm and ectopic and retrograde activation. Findings confirm the presence of paths with relatively rapid conduction in the atria and demonstrate that these are related to gross anatomic features. Findings also demonstrate that the paths are accessible to activation from multiple sites rather than insulated conduction paths with limited sites for entry and exit of activation.

Conduction Properties of the Crista Terminalis and Its Influence on the Right Atrial Activation Sequence in Patients with Typical Atrial Flutter

2002 ◽  
Vol 25 (2) ◽  
pp. 132-141 ◽  
Author(s):  
HIROSHIGE YAMABE ◽  
IKUO MISUMI ◽  
HIRONOBU FUKUSHIMA ◽  
KAZUHIRO UENO ◽  
YOSHIHIRO KIMURA ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Right Atrial ◽  
Crista Terminalis ◽  
Typical Atrial Flutter ◽  
Atrial Activation ◽  
The Right ◽  
Conduction Properties ◽  
Activation Sequence

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

2002 ◽  
Vol 13 (11) ◽  
pp. 1152-1159 ◽  
Author(s):  
TIM R. BETTS ◽  
SIEW YEN HO ◽  
DAMIAN SANCHEZ-QUINTANA ◽  
PAUL R. ROBERTS ◽  
ROBERT H. ANDERSON ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Three Dimensional ◽  
Right Atrial ◽  
Three Dimensional Mapping ◽  
Atrial Activation ◽  
Dimensional Mapping

Abstract 16295: Human Epicardial Bipolar Electrograms Prolong and Reduce in Amplitude Prior to Induction of Peri-Operative Atrial Fibrillation and Are Related to Sites of High Electrogram Dominant Frequency in Sinus Rhythm

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Junaid Zaman ◽  
Leanne Harling ◽  
Thanos Athanasiou ◽  
Nicholas S Peters
Keyword(s):  
Sinus Rhythm ◽  
Artery Bypass ◽  
Dominant Frequency ◽  
Bypass Grafting ◽  
Activation Time ◽  
Frequency Domains ◽  
Cycle Lengths ◽  
Electrophysiological Findings ◽  
Atrial Activation ◽  
Right Atria

Background: The exact trigger/substrate interactions leading to post-operative AF are unknown. Sites of high DF in sinus rhythm are proposed to harbor ‘fibrillar myocardium’ or ‘AF nests’. We studied AF inducibility related to putative upstream substrate changes by characterising epicardial electrograms (EGM) in both time and frequency domains. Method: AF naïve patients (n=14) undergoing coronary artery bypass grafting (CABG) had bipolar electrograms recorded from the lateral right atria (RA) wall with a high density spiral catheter, sampled at 1kHz. RA burst pacing at cycle lengths (CL) of 200, 500 and 1000ms was performed with any episodes of AF > 30s recorded. Electrograms were analysed using an average of 5 consecutive beats for duration, peak to peak amplitude, dominant frequency (DF) and activation time at all bipole pairs during every pacing drive train (total EGMs analysed 3430). Results: Bipolar EGM duration was significantly longer during AF (mean = 76.64ms, SD = 29.35ms) than all other CLs or NSR (p<0.0001). There was no difference between CLs but a trend to longer EGM at 200ms CL. EGM amplitude was significantly smaller during AF (mean = 0.85mV, SD = 0.51mv) vs. 500ms CL and NSR (p<0.0001) and at 200ms vs. 500ms CL (p<0.05) and NSR (p<0.0001). The EGM DF was significantly lower in AF (mean = 75.87Hz, SD = 23.63Hz) vs NSR (mean = 89.33Hz, SD = 25.99Hz) (p<0.05) but not vs. pacing CLs. Activation time was significantly prolonged at 200ms CL (mean = 29.41ms, SD = 16.23ms) vs AF and NSR (p<0.001 and 0.05 respectively). Conclusions: Human bipolar EGMs prolong and reduce in amplitude in induced peri-operative AF than in NSR or pacing. Atrial activation slows at 200ms CL, prior to initiation of AF. These changes are accompanied by high DF sites in NSR which may reveal underlying ‘AF nests’ even in non-remodelled atria. These novel peri-operative electrophysiological findings suggest upstream substrate changes which may predispose patients to post-operative AF.

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

2004 ◽  
Vol 15 (5) ◽  
pp. 524-531 ◽  
Author(s):  
FRANCISCO G. COSÍO ◽  
ARTURO MARTÍN-PEÑATO ◽  
AGUSTÍN PASTOR ◽  
AMBROSIO NÚÑEZ ◽  
MARÍA ANTONIA MONTERO ◽  
...  
Keyword(s):  
Sinus Rhythm ◽  
Clinical Electrophysiology ◽  
Atrial Activation ◽  
Activation Mapping

Comparative effects of single- and linear triple-site rapid bipolar pacing on atrial activation in canine models

2005 ◽  
Vol 289 (1) ◽  
pp. H374-H384 ◽  
Author(s):  
Kyungmoo Ryu ◽  
Raja N. Ghanem ◽  
Celeen M. Khrestian ◽  
Naomichi Matsumoto ◽  
Robert N. Goldstein ◽  
...  
Keyword(s):  
Wave Front ◽  
Velocity Vector ◽  
Conduction Block ◽  
Front Propagation ◽  
Right Atrial ◽  
Absolute Velocity ◽  
Crista Terminalis ◽  
Rapid Pacing ◽  
Atrial Activation ◽  
Wave Front Propagation

Nonuniform conduction may cause block and/or delay, thereby providing a substrate for the onset and maintenance of reentrant atrial arrhythmias. We tested the hypothesis that linear triple-site, bipolar, rapid pacing (LTSBRP) of the right atrium generates more uniform wave-front propagation compared with single-site, bipolar, rapid pacing (SSBRP), thereby reducing and/or eliminating conduction block and delay that is otherwise present. Five dogs with pericarditis and three normal dogs were studied. Three plunge-wire electrode pairs were placed 5–7 mm apart in both perpendicular and parallel configurations at the superior aspect of the crista terminalis and were used to pace at 200- and 300-ms cycle lengths for ≤6 s. During pacing, 380 electrograms were recorded simultaneously from electrode arrays placed epicardially on the atria, which produced activation sequence maps for each pacing episode. Local conduction-velocity vectors were computed for each site during each episode. Histograms of absolute velocity vector angles from the x-axis (of the crista terminalis) were plotted to assess uniformity of wave-front propagation, and the magnitude of each vector was computed to assess the local speed. LTSBRP showed 1) more uniform linear activation wave fronts compared with SSBRP, 2) velocity vectors with a more uniform magnitude and direction compared with SSBRP, 3) a predominant absolute velocity vector angle vs. a scattered angle distribution with SSBRP, and 4) shorter right atrial activation time and faster mean epicardial speed than SSBRP for each pacing cycle length. LTSBRP created a more uniform wave-front propagation with less or no conduction block and/or delay compared with SSBRP.

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