title: Three-dimensional electroanatomical mapping of right periatriotomy tachycardias after interatrial defect correction.
abstract: BACKGROUND
  Pericicatricial right intra-atrial reentrant tachycardias occur frequently in patients who have undergone surgical correction of an interatrial defect.
  
  
  OBJECTIVE
  To characterize the tachycardia circuits using three-dimensional electroanatomical mapping.
  
  
  METHODS
  Twelve tachycardias were analysed in 11 patients who had undergone surgical correction of an interatrial defect. Patients were divided into two groups: atrial flutter with typical sawtooth flutter waves in inferior leads, atrial tachycardia with clearly delimited P waves separated by an isoelectric line.
  
  
  RESULTS
  Seven tachycardias were classified as atrial flutter; three-dimensional mapping identified a peritricuspid circuit with inferior vena cava-tricuspid annulus isthmus involvement in all cases. All atrial flutters were terminated by linear ablation of this isthmus. Five tachycardias were classified as atrial tachycardia; three-dimensional mapping identified periatriotomy loops. All atrial tachycardias were ablated successfully between two scars or between a scar and an anatomical barrier.
  
  
  CONCLUSIONS
  Periatriotomy loops were always associated with an atrial tachycardia electrocardiogram pattern. Three-dimensional electroanatomical mapping appeared to be particularly useful for circuit identification and for ablation of these complex arrhythmias.
authors.affiliation: Department of clinical electrophysiology, institut du coeur, hôpital Pitié-Salpêtrière, 75013 Paris, France. franck.halimi@club-internet.fr
authors.forename: Franck
authors.initials: F
authors.lastname: Halimi
authors.forename: Manlio
authors.initials: M
authors.lastname: Marquez
authors.forename: Jérome
authors.initials: J
authors.lastname: Lacotte
authors.forename: Françoise
authors.initials: F
authors.lastname: Hidden-Lucet
authors.forename: Joelci
authors.initials: J
authors.lastname: Tonet
authors.forename: Robert
authors.initials: R
authors.lastname: Frank
mesh_terms: D000328:Adult; D000368:Aged; D001282:Atrial Flutter / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D018780:Body Surface Potential Mapping / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D017115:Catheter Ablation; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000601:surgery*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013617:Tachycardia, Supraventricular / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery