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Superior Tricuspid Annulus (superior + tricuspid_annulus)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

Atrial Morphology in Hearts with Congenitally Corrected Transposition of the Great Arteries: Implications for the Interventionist

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2002
RAJNISH JUNEJA M.D.
Atrial Morphology in Congenitally Corrected Transposition.Introduction: In view of the possible need for septal puncture to ablate left-sided lesions and the occasional difficulty in coronary sinus (CS) cannulation, we investigated relevant anatomic features in the right atrium of hearts with congenitally corrected transposition of the great arteries (ccTGA). Methods and Results: Nine hearts with ccTGA and an intact atrial septum and eight weight-matched normal hearts were examined by studying the "septal" aspect of the right atrium with reference to the oval fossa (OF). The anterior margin was arbitrarily measured as the shortest distance from the OF to the superior mitral/tricuspid annulus. The posterior margin was measured from the OF to the posterior-most edge of the right atrial "septal" surface. The total "septal" surface width was measured at the middle of the OF. The stretched OF dimensions and CS isthmus length were noted. Mann-Whitney test was used to compare absolute and indexed dimensions, i.e.. normalized to total width. The posterior margin in hearts with ccTGA was shorter than in controls (6.3 ± 2.4 mm vs 11 ± 1.9 mm, P < 0.001; normalized margin P = 0.09). The CS isthmus also was significantly shorter (5.3 ± 2.7 mm vs 11.4 ± 2.2 mm, P < 0.001). In two hearts with ccTGA, the CS opening into the right atrium was on the same side of the eustachian valve as the inferior caval vein. Conclusion: The shorter posterior "septal" margin in hearts with ccTGA may increase the risk of exiting the heart while performing septal puncture when pointing the needle posteriorly. The shorter CS isthmus and the abnormal location of the CS opening in some of these hearts are important when contemplating radiofrequency ablation in this area. [source]

Electrophysiologic and electrocardiographic characteristics of focal atrial tachycardia arising from superior tricuspid annulus

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2008
J. X. Yin
Summary Objectives:, This study describes the electrophysiologic and electrocardiographic characteristics of focal atrial tachycardia (AT) arising from superior tricuspid annulus in six (1.9%) patients of a consecutive series of 320 patients. Methods:, Six patients (mean age 42 ± 22 years) with a mean cycle length of 326 ms of a consecutive series of 320 patients undergoing radiofrequency ablation for focal AT were mapped. Results:, During electrophysiologic study, tachycardia could be induced in five patients with programmed atrial extrastimuli while a spontaneous onset and offset with ,warm-up and cool-down' phenomenon was seen in the other patient. During tachycardia, P-wave morphology in Lead I, II, III and aVF was upright in all the six patients. The precordial leads were dominantly negative or isoelectric in V1,V2 and positive in V5,V6 with a transition at V3 or V4. Moreover, the tachycardia was sensitive to intravenous administration of adenosine triphosphate in five of six patients. Conclusions:, Radiofrequency ablation was performed successfully in all patients (mean 4.5 ± 1.2 applications). No recurrence of AT was observed after a mean follow-up of 8 ± 6 months. Thus, AT arising from superior tricuspid annulus is rare. Radiofrequency ablation of this kind of AT is safe and effective. [source]

Three-Dimensional Mapping of Atypical Right Atrial Flutter Late after Chest Stabbing

PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2008
DANIEL STEVEN M.D.
We present the case of a female patient who previously underwent cardiac surgery for traumatic anterior right atrial perforation after a stabbing attack. Four years later the patient presented with right atrial common type flutter and isthmus ablation was performed subsequently. However, three years after isthmus ablation the patient was readmitted with atypical right atrial flutter. Electrophysiological study revealed persistent bidirectional isthmus block. Three-dimensional mapping (NavX, St. Jude Medical, St. Paul, MN, USA) demonstrated an incisional tachycardia with the critical isthmus at the border of the anterior area of scar in a close proximity to the superior tricuspid annulus. After ablation of this isthmus the patient was arrhythmia free after a follow-up of 9 months. This case illustrates that three-dimensional scar mapping may help to identify unusual isthmus sites that may be simultaneously responsible for both typical and atypical atrial flutter. [source]