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Researchers report distinct initial atrial activation patterns in noncoronary aortic sinus-atrial tachycardia
Liu X. J Am Coll Cardiol. 2010;56:796-804.
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An almost simultaneous activation of the biatrial paraseptal region and diffuse area of initial activation in each of the atria are included as the distinctive initial activation patterns of noncoronary aortic sinus-atrial tachycardia, researchers have documented in a new study.
The group of researchers from China, France and the United Kingdom utilized 3-D electroanatomic mapping during noncoronary aortic sinus-atrial tachycardia (NCAS-AT) in 13 patients and during pacing sequentially from the noncoronary aortic sinus (NCAS) and the para-Hisian atrial area in 15 reference patients. Researchers also used CT in 25 additional reference patients — and gross and microscopic anatomic examination in 12 human hearts — to analyze the spatial relationship between the NCAS and the contiguous atria.
According to study results, the para-Hisian area of the right atrium and the anteroseptal region of the left atrium were activated almost simultaneously during NCAS-AT. Researchers also reported that the initial activation area was relatively wide (9.3 ± 2.6 cm² on the right atrium map; 8.1 ± 2.1 cm² on the left atrium map).
Additionally, NCAS pacing in reference patients reproduced a biatrial activation pattern of NCAS-AT and resulted in a wider initial activation area than para-Hisian atrial pacing within first 20 ms of right atrium activation.
“These activation patterns have implications in improved diagnosis of NCAS-AT, thereby minimizing the risk of inadvertent ablation in the para-Hisian region,” the researchers commented in the concluding statement of their study. “Moreover, in the absence of myocardial tissue in the NCAS, peri-NCAS-AT may be an appropriate terminology.”
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