title: Usefulness of a crista catheter for 3-dimensional electroanatomical mapping of complex right atrial tachyarrhythmias.
abstract: OBJECTIVE
  Right atrial (RA) tachyarrhythmias are not rare in patients with congenital heart disease and a history of cardiac surgery. This study investigated the usefulness of a crista catheter for 3-dimensional electroanatomical mapping of RA tachyarrhythmias.
  
  
  METHODS
  We consecutively included 35 patients (age, 43.2 ± 15.6 years; 15 men) who underwent an electrophysiological study with 3-dimensional electroanatomical mapping for RA tachycardia or flutter. In 13 patients with atrial flutter, we recorded and compared the electrical sequence in the anterior and posterior portions of the RA lateral wall. We used a crista catheter as a mapping catheter for 3-dimensional mapping in 12 patients (crista group), a lasso catheter in 12 patients (lasso group), and an ablation catheter in 11 patients (ablation group). We compared the 3-dimensional mapping points, time, and speed (mapping points per minute) among the groups.
  
  
  RESULTS
  Atrial flutter was confirmed as cavotricuspid isthmus-dependent in all patients whose two atrial electrical sequences were the same direction and as atypical (including scar-related and dual-loop) in all patients whose sequences were in the opposite direction. Mapping speed in the crista group was significantly faster than in the lasso and ablation groups: median (interquartile range) 44.0 (35.5-69.4) points/min, 23.7 (17.8-29.8) points/min, and 8.2 (4.8-11.0) points/min, respectively (p = 0.001).
  
  
  CONCLUSIONS
  A crista catheter is useful for high-density 3-dimensional electroanatomical mapping of complex RA tachyarrhythmias. Comparison of the electrical sequences in the anterior and posterior portions of the RA lateral wall is helpful for differentiating between cavotricuspid isthmus-dependent and atypical atrial flutter.
authors.affiliation: Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, South Korea, 120-752.
authors.forename: Jae-Sun
authors.initials: JS
authors.lastname: Uhm
authors.affiliation: Department of Pediatric Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, South Korea.
authors.forename: Nam Kyun
authors.initials: NK
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, South Korea, 120-752.
authors.forename: Hancheol
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, South Korea, 120-752.
authors.forename: Tae-Hoon
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, South Korea, 120-752.
authors.forename: Boyoung
authors.initials: B
authors.lastname: Joung
authors.affiliation: Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, South Korea, 120-752.
authors.forename: Hui-Nam
authors.initials: HN
authors.lastname: Pak
authors.affiliation: Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro Seodaemun-gu, Seoul, South Korea, 120-752. mhlee@yuhs.ac.
authors.forename: Moon-Hyoung
authors.initials: MH
authors.lastname: Lee
mesh_terms: D000328:Adult; D018780:Body Surface Potential Mapping / Q000295:instrumentation*; D062906:Cardiac Catheters; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D006325:Heart Atria; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013612:Tachycardia, Ectopic Atrial / Q000175:diagnosis* / Q000601:surgery; D055815:Young Adult
keywords: Atrial flutter; Atrial tachycardia; Crista catheter; Right atrium; Three-dimensional mapping