Atrial macroreentry involving the myocardium of the coronary sinus

A unique mechanism for atypical flutter

Jeffrey E. Olgin, J. Vijay Jayachandran, Erica Engesstein, William Groh, Douglas P. Zipes

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Atrial flutter involving either clockwise or counterclockwise rotation around the tricuspid annulus utilizing the subeustachian isthmus has been well described. However, macroreentrant atrial circuits in atypical atrial flutter in patients who have not undergone previous surgery or without atrial disease are not well defined. We describe a patient without structural heart disease who presented with an atrial macroreentrant rhythm. Entrainment mapping demonstrated a critical isthmus within the coronary sinus. Activation mapping demonstrated double potential throughout the length of the coronary sinus with disparate activation sequences. A circuit involving the myocardium of the coronary sinus, exiting in the lateral left atrium, down the interatrial septum, and reentering into the coronary sinus was identified. Successful ablation of the rhythm was accomplished by a circumferential radiofrequency application within the coronary sinus.

Original languageEnglish
Pages (from-to)1094-1099
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume9
Issue number10
StatePublished - 1998

Fingerprint

Coronary Sinus
Myocardium
Atrial Flutter
Heart Atria
Heart Diseases

Keywords

  • Ablation
  • Atrial flutter
  • Atrial tachycardia
  • Atrium
  • Coronary sinus
  • Tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Atrial macroreentry involving the myocardium of the coronary sinus : A unique mechanism for atypical flutter. / Olgin, Jeffrey E.; Jayachandran, J. Vijay; Engesstein, Erica; Groh, William; Zipes, Douglas P.

In: Journal of Cardiovascular Electrophysiology, Vol. 9, No. 10, 1998, p. 1094-1099.

Research output: Contribution to journalArticle

Olgin, Jeffrey E. ; Jayachandran, J. Vijay ; Engesstein, Erica ; Groh, William ; Zipes, Douglas P. / Atrial macroreentry involving the myocardium of the coronary sinus : A unique mechanism for atypical flutter. In: Journal of Cardiovascular Electrophysiology. 1998 ; Vol. 9, No. 10. pp. 1094-1099.
@article{6ad0794e52a04075b84099332cd2a481,
title = "Atrial macroreentry involving the myocardium of the coronary sinus: A unique mechanism for atypical flutter",
abstract = "Atrial flutter involving either clockwise or counterclockwise rotation around the tricuspid annulus utilizing the subeustachian isthmus has been well described. However, macroreentrant atrial circuits in atypical atrial flutter in patients who have not undergone previous surgery or without atrial disease are not well defined. We describe a patient without structural heart disease who presented with an atrial macroreentrant rhythm. Entrainment mapping demonstrated a critical isthmus within the coronary sinus. Activation mapping demonstrated double potential throughout the length of the coronary sinus with disparate activation sequences. A circuit involving the myocardium of the coronary sinus, exiting in the lateral left atrium, down the interatrial septum, and reentering into the coronary sinus was identified. Successful ablation of the rhythm was accomplished by a circumferential radiofrequency application within the coronary sinus.",
keywords = "Ablation, Atrial flutter, Atrial tachycardia, Atrium, Coronary sinus, Tachycardia",
author = "Olgin, {Jeffrey E.} and Jayachandran, {J. Vijay} and Erica Engesstein and William Groh and Zipes, {Douglas P.}",
year = "1998",
language = "English",
volume = "9",
pages = "1094--1099",
journal = "Journal of Cardiovascular Electrophysiology",
issn = "1045-3873",
publisher = "Wiley-Blackwell",
number = "10",

}

TY - JOUR

T1 - Atrial macroreentry involving the myocardium of the coronary sinus

T2 - A unique mechanism for atypical flutter

AU - Olgin, Jeffrey E.

AU - Jayachandran, J. Vijay

AU - Engesstein, Erica

AU - Groh, William

AU - Zipes, Douglas P.

PY - 1998

Y1 - 1998

N2 - Atrial flutter involving either clockwise or counterclockwise rotation around the tricuspid annulus utilizing the subeustachian isthmus has been well described. However, macroreentrant atrial circuits in atypical atrial flutter in patients who have not undergone previous surgery or without atrial disease are not well defined. We describe a patient without structural heart disease who presented with an atrial macroreentrant rhythm. Entrainment mapping demonstrated a critical isthmus within the coronary sinus. Activation mapping demonstrated double potential throughout the length of the coronary sinus with disparate activation sequences. A circuit involving the myocardium of the coronary sinus, exiting in the lateral left atrium, down the interatrial septum, and reentering into the coronary sinus was identified. Successful ablation of the rhythm was accomplished by a circumferential radiofrequency application within the coronary sinus.

AB - Atrial flutter involving either clockwise or counterclockwise rotation around the tricuspid annulus utilizing the subeustachian isthmus has been well described. However, macroreentrant atrial circuits in atypical atrial flutter in patients who have not undergone previous surgery or without atrial disease are not well defined. We describe a patient without structural heart disease who presented with an atrial macroreentrant rhythm. Entrainment mapping demonstrated a critical isthmus within the coronary sinus. Activation mapping demonstrated double potential throughout the length of the coronary sinus with disparate activation sequences. A circuit involving the myocardium of the coronary sinus, exiting in the lateral left atrium, down the interatrial septum, and reentering into the coronary sinus was identified. Successful ablation of the rhythm was accomplished by a circumferential radiofrequency application within the coronary sinus.

KW - Ablation

KW - Atrial flutter

KW - Atrial tachycardia

KW - Atrium

KW - Coronary sinus

KW - Tachycardia

UR - http://www.scopus.com/inward/record.url?scp=0031724444&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031724444&partnerID=8YFLogxK

M3 - Article

VL - 9

SP - 1094

EP - 1099

JO - Journal of Cardiovascular Electrophysiology

JF - Journal of Cardiovascular Electrophysiology

SN - 1045-3873

IS - 10

ER -