Electrophysiologic characteristics of atrial tachycardia originating from the right pulmonary veins or posterior right atrium: double potentials obtained from the posterior wall of the right atrium can be useful to predict foci of atrial tachycardia in right pulmonary veins or posterior right atrium.
BACKGROUND
The right pulmonary veins (RPVs) and posterior wall of the right atrium (PRA) are anatomically located adjacent to each other. The aim of this study was to demonstrate the electrophysiologic characteristics of atrial tachycardia (AT) originating from the PRA or RPVs.


RESULTS
A total of 26 consecutive patients with AT originating from the RPVs or PRA underwent detailed atrial endocardial mapping and successful radiofrequency catheter ablation. Eight foci were found in the PRA and 18 foci in the RPVs. Analysis of P wave configuration showed that lead V1 was the most helpful in distinguishing the AT foci between these two sites. In all cases, double potential (DP) configurations were recorded from several electrodes of a multielectrode catheter placed in the PRA, and the first DP component (FP) was the earliest potential recorded from the right atrium during the tachycardia. The amplitude of the FP was higher than that of the second DP component (SP) for AT foci originating in the PRA, whereas the reverse occurred for those in the RPV. The activation sequence of the FP was from superior to inferior for the AT foci in the superior RPV, whereas the reverse occurred for the AT foci in the inferior RPV.


CONCLUSIONS
P wave configuration in lead V1 is helpful in distinguishing AT foci between those originating in the PRA and RPVs. The DPs obtained from the PRA can be useful in predicting whether AT foci originate from the PRA or RPVs.
Yamada
Takumi
T
Division of Cardiology, Aichi Prefectural Owari Hospital, Cardiovascular Center, Ichinomiya, Japan. takumi-y@fb4.so-net.ne.jp
Murakami
Yoshimasa
Y
Muto
Masahiro
M
Okada
Taro
T
Okamoto
Mitsuhiro
M
Toyama
Junji
J
Yoshida
Yukihiko
Y
Tsuboi
Naoya
N
Ito
Teruo
T
Kondo
Takahisa
T
Inden
Yasuya
Y
Hirai
Makoto
M
Murohara
Toyoaki
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D016009:Chi-Square Distribution; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013612:Tachycardia, Ectopic Atrial / Q000503:physiopathology* / Q000601:surgery