title: A case of cor triatriatum with an abnormal P wave: the pacemaker action from the specialized tissue in the abnormal septum.
abstract: A boy presented with an abnormal P wave shown on an electrocardiogram (ECG) checkup at school. An echocardiogram and contrast-enhanced computed tomography (CT) showed cor triatriatum with a slit-like opening between the accessory chamber and the left atrium located along the interatrial septum. The boy underwent open heart surgery for excision of the anomalous membrane, and a postoperative ECG showed normal P waves. The excised tissue was examined immnunohistopathologically using antihyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4) antibody and other staining. The authors confirmed the existence of cells positive to HCN4, indicating that they were sinoatrial node cells or at least cells with electrical automaticity.
authors.affiliation: Department of Pediatrics, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan. yoshimichi.kudo@mt.strins.or.jp
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Kudo
authors.forename: Mariko
authors.initials: M
authors.lastname: Kaneko
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakazawa
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tomita
mesh_terms: D002648:Child; D003310:Cor Triatriatum / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology* / Q000601:surgery; D054815:Cyclic Nucleotide-Gated Cation Channels / Q000378:metabolism; D004562:Electrocardiography; D006329:Heart Conduction System / Q000002:abnormalities* / Q000473:pathology; D006346:Heart Septum / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels; D007150:Immunohistochemistry; D008297:Male; D009124:Muscle Proteins / Q000378:metabolism; D015221:Potassium Channels; D012849:Sinoatrial Node / Q000473:pathology
chemical_list: D054815:Cyclic Nucleotide-Gated Cation Channels; C119587:HCN4 protein, human; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels; D009124:Muscle Proteins; D015221:Potassium Channels