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Case Reports
. 2015 Feb 12;1(2):78-81.
doi: 10.1016/j.hrcr.2015.01.017. eCollection 2015 Mar.

Electrophysiological characteristics of a left atrial anomalous muscular band in a case with paroxysmal atrial fibrillation

Shunsuke Uetake  1 , Yasushi Miyauchi  1 , Meiso Hayashi  1 , Wataru Shimizu  1
Affiliations
Case Reports

Electrophysiological characteristics of a left atrial anomalous muscular band in a case with paroxysmal atrial fibrillation

Shunsuke Uetake et al. HeartRhythm Case Rep. .
No abstract available

Keywords: AF, atrial fibrillation; Arrhythmogenesis; Atrial fibrillation; Intracardiac echocardiography; LA, left atrium/atrial; Left atrium; PV, pulmonary vein; Transesophageal echocardiogram; Working cardiac muscle; electrophysiological study.

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Figures

Figure 1
Figure 1
A: Transesophageal echocardiogram. The anomalous band, indicated by the arrows, was attached to the posterior rim of the fossa ovalis (arrowheads). B: Intracardiac echocardiogram from the left atrium (LA), showing a cross-section of the anomalous band (AB). Note that the map catheter (Map) was in contact with the AB. C: Left anterior oblique (LAO) cranial view (left panel) and left lateral (LL) endoscopic view (middle panel) of the activation map of the AB during sinus rhythm merged with the 3-dimensional computed tomographic image, showing that activation propagates from both ends of the AB and collides in the middle. The right panel shows the ablation lesion sets. Red and pink tags represent the ablation sites for the circumferential PV isolation and LA roof line, respectively. Cra = cranial; LSPV = left superior pulmonary vein; RA = right atrium; RIPV = right inferior pulmonary vein; RSPV = right superior pulmonary vein; Sept = septal.
Figure 2
Figure 2
Activation sequence of the decapolar catheter located along the anomalous band (AB) in the left atrium (LA) during sinus rhythm before ablation. A: Activation during sinus rhythm before ablation, showing activation propagating from both ends and colliding in the middle. B: Activation during septal pacing, showing activation propagating from the septal end of the AB. C: Activation during pacing from the roof of the LA, showing activation propagating from the posterior LA side of the AB. D: Activation during sinus rhythm after the antral pulmonary vein isolation and roof ablation, showing entrance block from the posterior LA side of the AB. CS = coronary sinus; d = distal; p = proximal; PLA = posterior wall of the left atrium; RA = right atrium.
Figure 3
Figure 3
A: Local electrogram of the decapolar catheter located along the anomalous band during pacing from the roof of the left atrium at a rate of 100 beats/min. The conduction time from the distal pair to the proximal pair was measured. B: Conduction time of the anomalous band at various pacing rates. C: Conduction velocity calculated from the conduction time between the 2 pairs of electrodes. CS = coronary sinus; p = proximal; RA = right atrium; Stim = pacing stimulus artifact.
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