title: Pulmonary artery mapping for differential diagnosis of left-sided atrial tachycardia.
abstract: BACKGROUND
  Distinguishing left-and right-sided atrial tachycardia (AT) is often challenging. The coronary sinus (CS) provides information only concerning the anterior left atrium (LA). Potentials recorded in the pulmonary artery (PA) have been substituted for those of the upper posterior LA because of their anatomical relationship.
  
  
  RESULTS
  Three patterns were designed, using potentials in the PA, right atrium (RA) and CS, to predict the side of AT. Two patterns were for left-sided AT and 1 pattern was for right-sided AT. Ten left-sided and 11 right-sided ATs were investigated regardless of mechanism. Electrode catheters were inserted in the RA, His bundle region, and CS, and an ablation catheter was inserted into the left and/or right PA. The sequences from these catheters were analyzed before detailed electroanatomical mapping. Patterns were obtained for 20 of 21 ATs. The mechanism was focal in 16 ATs and macroreentry in 5. The method predicted left-sided AT with a sensitivity of 78%, a specificity of 100%, a positive predictive value of 100%, a negative predictive value of 84%, and an accuracy of 90%.
  
  
  CONCLUSIONS
  The use of potentials in PA combined with conventional RA and CS electrograms is useful for distinguishing left-sided AT from right-sided AT, regardless of mechanism.
authors.affiliation: Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Science, Hiroshima 734-8551, Japan.
authors.forename: Yukoh
authors.initials: Y
authors.lastname: Hirai
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Nakano
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Kazuyoshi
authors.initials: K
authors.lastname: Suenari
authors.forename: Noboru
authors.initials: N
authors.lastname: Oda
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Ueda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Makita
authors.forename: Kenta
authors.initials: K
authors.lastname: Kajihara
authors.forename: Yasuki
authors.initials: Y
authors.lastname: Kihara
mesh_terms: D000328:Adult; D000368:Aged; D002036:Bundle of His / Q000503:physiopathology / Q000601:surgery; D006328:Cardiac Catheterization / Q000379:methods; D017115:Catheter Ablation; D054326:Coronary Sinus / Q000503:physiopathology* / Q000601:surgery; D003937:Diagnosis, Differential; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods* / Q000592:standards; D005260:Female; D006325:Heart Atria / Q000503:physiopathology / Q000601:surgery; D006329:Heart Conduction System / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000503:physiopathology* / Q000601:surgery; D015203:Reproducibility of Results; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery