Three Dimensional Electroanatomical Mapping of Lower Loop Reentry in Patients with Intracardiac Operation

Three Dimensional Electroanatomical Mapping of Lower Loop Reentry in Patients with Intracardiac Operation

Introduction: The aim of this study was to clarify the characteristics of lower loop reentry (LLR. in patients who underwent cardiac surgery. Methods: Of 194 patients from 2000 to 2007 with negative flutter waves in the inferior leads (II, III, and aVf), 4 patients had LLR and reentrant circuits ide...

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Bibliographic Details
Main Authors: Hiro Kawata, MD, Kazuhiro Suyama, MD, PhD, Miki Yokoawa, MD, Kenichiro Yamagata, MD, Teruki Yokoyama, MD, Hisaki Makimoto, MD, Atsushi Doi, MD, PhD, Yuko Yamada, MD, PhD, Hideo Okamura, MD, Takashi Noda, MD, PhD, Kazuhiro Satomi, MD, PhD, Wataru Shimizu, MD, PhD, Naohiko Aihara, MD, Shiro Kamakura, MD, PhD
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Journal of Arrhythmia
Subjects:
Lower loop reentry
Atrial flutter
Body surface electrocardiogram
Online Access:http://www.sciencedirect.com/science/article/pii/S1880427611800062
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Summary:Introduction: The aim of this study was to clarify the characteristics of lower loop reentry (LLR. in patients who underwent cardiac surgery. Methods: Of 194 patients from 2000 to 2007 with negative flutter waves in the inferior leads (II, III, and aVf), 4 patients had LLR and reentrant circuits identified by a 3D activation sequence mapping system. We studied the characteristics of the surface electrocardiogram (ECG. patterns of those LLRs. Results: All 4 patients had a history of an intracardiac operation. The 3D activation sequence mapping system during the LLR exhibited a clockwise (CW. wavefront around the inferior vena cava (IVC. from the caudal view. During the LLR, the right atrium (RA. free wall was activated in a caudal-cranial sequence and a collision of two activation wavefronts from the lower RA and upper RA occurred at the RA free wall. Conclusions: The 3D activation mapping during the AT revealed an activation wavefront propagating around the IVC and the diagnosis of LLR. Detailed 3D electroanatomical mapping and pacing study are needed to identify the reentrant circuit of LLR in patients with previous intracardiac surgery.
ISSN:1880-4276

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