Endocardial electro-anatomic mapping in healthy horses: Normal sinus impulse propagation in the left and right atrium and the ventricles

Abstract Introduction Ischemic stroke is a leading cause of death and disability in the Western world, frequently due to cardioembolism and atherothromboembolism. Cryptogenic strokes occur without a well-defined aetiology after a standard vascular and cardiac evaluation, and secondary prevention may include antiplatelet therapy while awaiting results of long-term cardiac monitoring. In this study, we aimed to identify echocardiographic predictors of paroxysmal atrial fibrillation (AF) latter identified in follow-up of patients with cryptogenic stroke. Methods We retrospectively assessed all patients with cryptogenic stroke admitted in our hospital in the last 2 years. Only patients in normal sinus rhythm with a minimum of 24 hours of cardiac monitoring at admission and 24 hours Holter monitor within 6 months after discharge were included. Echocardiographic measures included left ventricle ejection fraction, left atrium (LA) volume, left and right atrium longitudinal strain, left and right ventricle longitudinal strain, E/A ratio, E/e' ratio, isovolumetric relaxation time (IVRT) and E wave deacceleration time. Echocardiographic data was assessed to determine its accuracy to identify AF. Results The study included 32 patients with a mean age of 72±10 years and a male preponderance (87.5%). AF was identified in 12 (37.5%) patients. This group of patients had a larger indexed LA volume (44.3 vs 29.1 mL/m2, p=0.043), a lower IVRT (87 vs 116 ms, p=0.028), and a lower LA longitudinal strain in contractile (6.7 vs 13.6%, p<0.001) and in reservoir phase (17.1 vs 23.6%, p=0.042). All other variables were not significantly different among groups, including LA longitudinal strain in conduit phase. LA longitudinal strain in contractile phase showed the best predictive power with an area under the ROC curve of 0.925 (95% CI 0.82–1 p=0.001). The cut-off value that best predicted AF was 8.17% with a sensitivity of 1 and specificity of 0.9. Conclusion LA longitudinal strain in contractile phase is a powerful method to identify AF in cryptogenic stroke. When reduced, anticoagulation may be considered in order to prevent recurrence. Further studies are warranted to reproduce these results in larger cohorts. Funding Acknowledgement Type of funding source: None

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Changes of electrophysiological parameters in patients with atrial flutter

Medicina ◽

10.3390/medicina43080078 ◽

2007 ◽

Vol 43 (8) ◽

pp. 614 ◽

Cited By ~ 1

Author(s):

Diana Žaliaduonytė-Pekšienė ◽

Tomas Kazakevičius ◽

Vytautas Zabiela ◽

Vytautas Šileikis ◽

Remigijus Vaičiulis ◽

...

Keyword(s):

Response Time ◽

Atrial Flutter ◽

Right Atrium ◽

Propagation Speed ◽

Control Group ◽

Type I ◽

Stimulus Response ◽

Refractory Periods ◽

Impulse Propagation ◽

The Right

Objectives. The aim of the study was to study some anatomic and electrophysiological features of the right atrium, related to the presence of atrial flutter. Materials and methods. A total 23 patients with type I atrial flutter and 22 patients without atrial flutter were studied. Right atrium size was assessed using echocardiography before intracardiac examination and radiofrequency ablation. Results. Effective refractory periods of coronary sinus, high right atrium, low right atrium were different comparing with the control group (P<0.05). A stimulus–response time between high right atrium and low right atrium positions in anterograde and retrograde ways, an impulse propagation speed along the lateral wall of the right atrium were statistically different comparing both groups (P<0.05). There was a significant correlation among effective refractory periods measured in different sites of the right atrium (r²=0.64, 0.44, 0.44, respectively). All measured effective refractory periods also correlated with stimulus–response time in anterograde way (P<0.05) and impulse propagation speed (P<0.05). Right atrium dimensions were significantly larger in atrial flutter group. There was no correlation between the right atrium dimensions and measured electrophysiological parameters in both groups.Conclusions. The presence of atrial flutter associates with diffuse alterations of the right atrium, but not the focal or single changes of refractoriness.

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Rac1-Induced Remodelling is Different in the Left and Right Atrium of RacET Mice

Biophysical Journal ◽

10.1016/j.bpj.2009.12.2983 ◽

2010 ◽

Vol 98 (3) ◽

pp. 551a

Author(s):

Peter Lipp ◽

Martin Oberhofer ◽

Qinghai Tian ◽

Jue Wang ◽

Karin Hammer ◽

...

Keyword(s):

Right Atrium ◽

Left And Right

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Bi-auricular myxoma associated with atrioventricular dissociation in an 18-year-old boy: a case report

Cardiology in the Young ◽

10.1017/s1047951111001533 ◽

2011 ◽

Vol 22 (3) ◽

pp. 341-343 ◽

Cited By ~ 2

Author(s):

Jacques C. Tantchou Tchoumi ◽

Alessandro Giamberti ◽

Silvia Cirri ◽

Gianfranco Butera

Keyword(s):

Case Report ◽

Right Atrium ◽

Interatrial Septum ◽

Right Atrial ◽

Open Heart ◽

Conduction Disturbances ◽

Cardiac Tumours ◽

Autopsy Series ◽

Atrioventricular Dissociation ◽

Left And Right

AbstractPrimary cardiac tumours are rarely found and have an incidence of 0.3% in all open-heart surgeries. Among those, approximately 70% are myxomas, most of them in the left atrium. The reported incidence of cardiac tumours in autopsy series is 0.001–0.28%. Right atrial myxomas are uncommon, but when present they often originate from the interatrial septum, and conduction disturbances are rarely noted as an accompanying feature in this condition. We report the case of an 18-year-old boy with a myxoma in both left and right atrium associated with atrioventricular dissociation.

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Pericardium modulates left and right ventricular stroke volumes to compensate for sudden changes in atrial volume

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00613.2002 ◽

2003 ◽

Vol 284 (6) ◽

pp. H2247-H2254 ◽

Cited By ~ 48

Author(s):

Carol A. Gibbons Kroeker ◽

Nigel G. Shrive ◽

Israel Belenkie ◽

John V. Tyberg

Keyword(s):

Stroke Volume ◽

Right Ventricular ◽

Left Atrium ◽

Right Atrium ◽

Transmural Pressure ◽

Atrial Volume ◽

Volume Changes ◽

Cardiac Volume ◽

Pericardial Pressure ◽

Left And Right

The pericardium may modulate acute compensatory changes in stroke volumes seen with sudden changes in cardiac volume, but such a mechanism has never been clearly demonstrated. In eight open-chest dogs, we measured left and right ventricular pressures, diameters, stroke volumes, and pericardial pressures during rapid (∼300 ms) systolic infusions or withdrawals of ∼25 ml blood into and out of the left atrium and right atrium. Control beats, the infusion/withdrawal beat, and 4–10 subsequent beats were studied. With infusions, ipsilateral ventricular end-diastolic transmural pressure, diameter, and stroke volume increased. With the pericardium closed, there was a compensatory decrease in contralateral transmural pressure, diameter, and stroke volume, mediated by opposite changes in transmural end-diastolic pressures. The sum of the ipsilateral increase and contralateral decrease in stroke volume approximated the infused volume. Corresponding changes were seen with blood withdrawals. This direct ventricular interaction was diminished when pericardial pressure was <5 mmHg and absent when the pericardium was opened. Pericardial constraint appears essential for immediate biventricular compensatory responses to acute atrial volume changes.

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Evaluation of Linear Lesions in the Left and Right Atrium in Ablation of Longstanding Atrial Fibrillation

Pacing and Clinical Electrophysiology ◽

10.1111/pace.12168 ◽

2013 ◽

pp. n/a-n/a

Author(s):

YUAN-LONG WANG ◽

XU LIU ◽

HONG-WEI TAN ◽

LI ZHOU ◽

WEI-FENG JIANG ◽

...

Keyword(s):

Atrial Fibrillation ◽

Right Atrium ◽

Linear Lesions ◽

Left And Right

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P1697 A rare case: primary cardiac sarcoma in the left and right atrium presenting with dispnea due to mitral valvular obstruction

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez319.1060 ◽

2020 ◽

Vol 21 (Supplement_1) ◽

Author(s):

S Akturk ◽

T S Tan ◽

M Mammadov ◽

I Dincer ◽

C Erol

Keyword(s):

Computed Tomography ◽

Left Atrium ◽

Right Atrium ◽

Bone Lesions ◽

Cardiac Tumors ◽

Iliac Wing ◽

Left And Right ◽

Primary Cardiac Sarcoma ◽

The Right ◽

Primary Cardiac Tumors

Abstract Introduction Primary cardiac tumors are extremely rare; the incidence is approximately 0.001% to 0.03%. Malignant tumors account for 25% of primary cardiac tumors, and among those, sarcomas are the most prevalent. We report a case of primary cardiac sarcoma presenting with dyspnea due to mitral valvuler obstruction. Case Report A 41-year-old woman was admitted to the hospital with dyspnea for 8 months without any obvious causes. She was healthy previous and without family history. Physical examination was normal. Thorax computed tomography (CT) scan was performed with the doubt of pulmonary disease. A 1x1 cm hypodense nodule was detected in superior segment of the right lower lobe lung. Positron emission tomography-computed tomography (PET-CT) revealed a 1*1 cm nodule in the lung. And also increased 18F-fluorodeoxyglucose uptake was observed in the left scapula, left iliac wing and right 4th rib, likely due to metastasis. Biopsy from the lesion of iliac wing was performed. Pathologic examination was primarily compatible with the malign mesenchymal tumor and sarcoma infiltration; but malignant epithelial tumor and metastasis of carcinoma could not be ruled out. Magnetic resonance imaging of the lung was performed to find the origin of the metastatic tumor. A 8,6 x 5,3 x 5,1 cm mass filling the right and left atria was detected.It was extending from the right atrium to the superior vena cava and also from the left atrium to the right inferior and superior pulmonary venules. The image of mass was compatible with sarcoma. Transthoracic echocardiography was performed. A mass in the left and right atrium was detected. It was filling the left atrium. Due to the mass, the maximum mitral gradient was 21 mm Hg and the mean mitral gradient was 10 mm Hg, as if there was mitral stenosis.Systolic pulmonary artery pressure was 40 mmHg. Mild mitral insufficiency was detected. The patient was evaluated with the department of oncology and cardiovascular surgery. It was decided that the mass was inoperable. So transesophageal echocardiography was not performed. It was thought that, the mass was primary cardiac sarcoma, pulmonary nodule and bone lesions were metastasis of this primary cardiac sarcoma. So chemotherapy protocol (ifosfamide,adriamycin,mesna) was started. Conclusion Cardiac tumors have many clinical presentations. Early stages of the disease are often asymptomatic. In advanced stages, patients present with symptoms of the classic triad (intracardiac obstruction, systemic embolization, constitutional symptoms) Symptoms are often non-spesific; so diagnostic suspicion is very important. Although cardiac sarcoma therapy includes complete surgical excision, followed by radiotherapy and chemotherapy, prognosis is still poor. Surgery can offer dramatic palliation of symptoms in cases of valvular obstruction. In conclusion, it remains clear that early diagnosis and treatment are extremely important because of their prognostic and therapeutic value. Abstract P1697 Figure.

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Thoracoscopic epicardial ablation of the left and right atrium. Beating heart procedure in patients with atrial fibrillation

Polish Archives of Internal Medicine ◽

10.20452/pamw.1216 ◽

2012 ◽

Vol 122 (5) ◽

pp. 189-194

Author(s):

Krzysztof Bartuś ◽

Andy C. Kiser ◽

Jacek Majewski ◽

Bogusław Kapelak ◽

Janusz Konstanty-Kalandyk ◽

...

Keyword(s):

Atrial Fibrillation ◽

Right Atrium ◽

Beating Heart ◽

Epicardial Ablation ◽

Left And Right

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Surgical management of biatrial myxoma: case report

Patologiya krovoobrashcheniya i kardiokhirurgiya ◽

10.21688/1681-3472-2021-4-118-123 ◽

2021 ◽

Vol 25 (4) ◽

pp. 118

Author(s):

T. A. Simonyan ◽

I. I. Scopin ◽

I. M. Tsiskaridze ◽

I. Yu. Farulova ◽

E. A. Babajanyan

Keyword(s):

Mitral Valve ◽

Surgical Management ◽

Tricuspid Valve ◽

Conflict Of Interest ◽

Right Atrium ◽

Left Ventricular ◽

Left Ventricular Ejection ◽

Support Ring ◽

Ventricular Ejection Fraction ◽

Left And Right

Heart tumours account for approximately 0.2 % of all tumours: of these, approximately 75 % of all primary heart tumours are benign and 50 % of them are myxomas. Further, myxomas make up 0.0017 % of the general population of patients with cardiovascular disease. Biatrial myxomas, i.e. tumours in both the left and right atria, can be in the form of a ‘butterfly’ or a ‘dumbbell’, and account for < 1 % of all cardiac myxomas. Here we describe the successful surgical management of a rare case of a large biatrial myxoma and concomitant atrioventricular valve insufficiency. Briefly, 2D transthoracic echocardiography findings included an end-diastolic volume of 90 ml, an end-systolic volume of 40 ml and a left ventricular ejection fraction of 55 % (according to Simpson). The fibrous ring of the mitral valve measured 36 mm with a regurgitation degree of 2 while the fibrous ring of the tricuspid valve was 42 mm in size and the regurgitation grade was 3. Lesion size in the cavity of the left and right atrium were 73 × 38 mm and 80 × 42 mm, respectively. These neoplasia were surgically removed under peripheral cardiopulmonary bypass, hypothermia and cold cardioplegia (Custodiol). The myxomas were accessed through the right atrium, according to Giradon and were resected without defragmentation. Next, mitral valve plasty using a soft support ring and annuloplasty of the tricuspid valve were performed according to de Vega. The duration of artificial circulation was 150 minutes and that of myocardial ischaemia was 100 minutes. The patient was extubated 11 hours after surgery, spent 22 hours in the intensive care unit and was discharged on the 14th day after surgery. Surgical resection of biatrial myxomas before the development of serious irreversible or life-threatening complications can provide rapid symptomatic relief in congestive heart failure.Received 30 May 2021. Revised 22 August 2021. Accepted 23 August 2021.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Contribution of the authors Literature review: T.A. Simonyan Drafting the article: T.A. Simonyan, I.M. Tsiskaridze Critical revision of the article: T.A. Simonyan, I.Yu. Farulova, E.A. Babajanyan Surgical treatment: I.I. Scopin, I.M. Tsiskaridze Final approval of the version to be published: T.A. Simonyan, I.I. Scopin, I.M. Tsiskaridze, I.Yu. Farulova, E.A. Babajanyan

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