Function follows form: When electrophysiology derives from anatomy
2017; Elsevier BV; Volume: 14; Issue: 9 Linguagem: Inglês
10.1016/j.hrthm.2017.06.024
ISSN1556-3871
Autores Tópico(s)Cardiac electrophysiology and arrhythmias
ResumoTackling an arrhythmia by its mapping and successful ablation demonstrates time and again the art of integrating function and form—or how the analysis of an arrhythmia and its successful treatment is essentially linked to its underlying anatomic substrate. Wilhelm His Jr, after whom the His bundle is named, first described the so-called “spina vestibuli”—the leading edge of the primary atrial septum, forming the buttress binding the atrial septum itself to the insulating tissues of the atrioventricular (AV) junctions. 1 Anderson R.H. Mori S. Wilhelm His Junior and his bundle. J Electrocardiol. 2016; 49: 637-643 Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar This structure, situated within the center of the heart, is bounded by the aortic and the AV valves, and is an area requiring abundant caution when ablating locally because of its proximity to the AV conduction system. However, the anatomy allows for approaching targets within this area not only from the right atrial (RA) as well as from the left atrial (LA) side but also from the aortic root, 2 Tada H. Naito S. Miyazaki A. Oshima S. Nogami A. Taniguchi K. Successful catheter ablation of atrial tachycardia originating near the atrioventricular node from the noncoronary sinus of Valsalva. Pacing Clin Electrophysiol. 2004; 27: 1440-1443 Crossref PubMed Scopus (55) Google Scholar with the aim of avoiding the AV conduction system as well as reaching profoundly situated arrhythmogenic tissue. Focal atrial tachycardias from the parahisian region: Strategies for mapping and catheter ablationHeart RhythmVol. 14Issue 9PreviewFocal atrial tachycardias (ATs) from the parahisian region can be successfully ablated from the right atrial septum (RAS), noncoronary cusp (NCC), and right middle septum (RMS). The optimal mapping and ablation strategy for ATs from these sites remains unclear. Full-Text PDF
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