title: Complex atrial reentrant circuits evaluated by entrainment mapping using a multielectrode basket catheter.
abstract: Atrial tachycardias after open heart surgery sometimes have complex reentrant circuits. A patient with a dual-loop atrial reentrant circuit occurring after mitral valve replacement was evaluated by entrainment mapping with a basket catheter. The position of the catheter was adjusted to obtain atrial electrograms of the anterior and posterior septal areas, the crista terminalis, the free wall, and the tricuspid annular region. Entrainment mapping identified a dual-loop reentry consisting of one circuit around the tricuspid annulus and another around the septal atriotomy scar. The reentrant circuit around the septal incision was eliminated by ablating the area between the septal incision and the inferior vena cava, and the circuit around the tricuspid annulus was terminated with an additional linear ablation between the tricuspid annulus and the inferior vena cava. Entrainment mapping using a multielectrode basket catheter is very useful for identifying complex atrial reentrant circuits.
authors.affiliation: The Second Department of Internal Medicine and Toyama Medical and Pharmaceutical University, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Nishida
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiki
authors.forename: Hidehiko
authors.initials: H
authors.lastname: Nagasawa
authors.forename: Masao
authors.initials: M
authors.lastname: Sakabe
authors.forename: Koichi
authors.initials: K
authors.lastname: Mizumaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Inoue
authors.forename: Takuro
authors.initials: T
authors.lastname: Misaki
mesh_terms: D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve; D013612:Tachycardia, Ectopic Atrial / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy