title: Detection of diastolic potentials around the mitral annulus of structurally normal human hearts.
abstract: To examine the electrophysiologic characteristics of the subvalvular mitral region, we retrospectively searched for the presence of subvalvular diastolic potentials (DP) in 91 patients (mean age, 46.9 ± 16.6 years) who underwent catheter ablation of left-sided accessory pathways (AP). We detected low-amplitude (0.19 ± 0.09 mV) DP in 14 patients (15.4%), including 8 with overt preexcitation and 6 patients with concealed AP. The mean interval between ventricular electrogram and DP was 383 ± 46 ms (range, 306-475). DP were detected in 4 of 20 patients with antero-lateral, 3 of 38 with lateral, 4 of 12 with postero-lateral, 2 of 14 with posterior, and 3 of 10 patients with postero-septal AP. In 6 of 14 patients, DP were detected before ablation. In 4 of 8 patients with overt preexcitation, DP were consistently recorded after elimination of the delta wave, suggesting that they were not associated with AP conduction. In 6 of 11 patients, DP were observed during both sinus rhythm and ventricular pacing, suggesting that they were not artifacts. The electrophysiologic characteristics of clinically relevant DP around the mitral annulus suggest that, in normal human hearts, an anatomical substrate may be present around the mitral annulus.
authors.affiliation: Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, Gunma, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Saito
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kaneko
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakajima
authors.forename: Tadanobu
authors.initials: T
authors.lastname: Irie
authors.forename: Masaki
authors.initials: M
authors.lastname: Ota
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Kato
authors.forename: Takafumi
authors.initials: T
authors.lastname: Iijima
authors.forename: Mio
authors.initials: M
authors.lastname: Tamura
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Toshio
authors.initials: T
authors.lastname: Ito
authors.forename: Mamoru
authors.initials: M
authors.lastname: Manita
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
mesh_terms: D000200:Action Potentials; D000328:Adult; D017115:Catheter Ablation; D003971:Diastole; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D012189:Retrospective Studies; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology* / Q000601:surgery