Atrial endocardial activation in man electrode catheter technique for endocardial mapping
Identifieur interne : 000741 ( Main/Corpus ); précédent : 000740; suivant : 000742Atrial endocardial activation in man electrode catheter technique for endocardial mapping
Auteurs : Mark E. Josephson ; Daniel L. Scharf ; John A. Kastor ; James G. Kitchen IiiSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1977.
Abstract
The sequence of antegrade atrial endocardial activation was evaluated in 49 patients: 24 with a normal P wave configuration, 15 with electrocardiographic criteria for left atrial enlargement and 14 with a variety of supraventricular arrhythmias. In 17 patients, 6 with and 11 without evidence of the Wolff-Parkinson-White syndrome, retrograde atrial activation sequence was analyzed during ventricular premature beats, junctional rhythm or supraventricular tachycardia. The recording sites included the high mid- and low right atrium the right atrioventricular (A-V) junction and the distal coronary sinus or the left atrium. In patients with normal P waves atrial activation began at either the high or the mid-right atrium and proceeded to the low right atrium and A-V junction and then the coronary sinus. A similar sequence of activation was noted In patients with left atrial enlargement, but activation at the coronary sinus was markedly delayed (77 ± 8 [mean ± standard deviation] versus 112 ± 14 msec, P <0.001). In 11 patients without preexcitation retrograde activation appeared earliest at the A-V junction then at the coronary sinus and high right atrium. Six patients with the Wolff-Parkinson-White syndrome had normal antegrade atrial activation, and five of the six demonstrated eccentric retrograde atrial activation during supraventricular tachycardia. This study suggests that atrial endocardial mapping is an important diagnostic tool for evaluating supraventricular tachycardias and atrial conduction disturbances.
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DOI: 10.1016/S0002-9149(77)80210-5
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Atrial endocardial activation in man electrode catheter technique for endocardial mapping</title><author><name sortKey="Josephson, Mark E" sort="Josephson, Mark E" uniqKey="Josephson M" first="Mark E." last="Josephson">Mark E. Josephson</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Scharf, Daniel L" sort="Scharf, Daniel L" uniqKey="Scharf D" first="Daniel L." last="Scharf">Daniel L. Scharf</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Kastor, John A" sort="Kastor, John A" uniqKey="Kastor J" first="John A." last="Kastor">John A. Kastor</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Kitchen Iii, James G" sort="Kitchen Iii, James G" uniqKey="Kitchen Iii J" first="James G." last="Kitchen Iii">James G. Kitchen Iii</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:89F80BCE663E7880C8EBF4047C81E12D9D684FBA</idno><date when="1977" year="1977">1977</date><idno type="doi">10.1016/S0002-9149(77)80210-5</idno><idno type="url">https://api.istex.fr/document/89F80BCE663E7880C8EBF4047C81E12D9D684FBA/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000741</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Atrial endocardial activation in man electrode catheter technique for endocardial mapping</title><author><name sortKey="Josephson, Mark E" sort="Josephson, Mark E" uniqKey="Josephson M" first="Mark E." last="Josephson">Mark E. Josephson</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Scharf, Daniel L" sort="Scharf, Daniel L" uniqKey="Scharf D" first="Daniel L." last="Scharf">Daniel L. Scharf</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Kastor, John A" sort="Kastor, John A" uniqKey="Kastor J" first="John A." last="Kastor">John A. Kastor</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author><author><name sortKey="Kitchen Iii, James G" sort="Kitchen Iii, James G" uniqKey="Kitchen Iii J" first="James G." last="Kitchen Iii">James G. Kitchen Iii</name><affiliation><mods:affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977">1977</date><biblScope unit="volume">39</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="972">972</biblScope><biblScope unit="page" to="981">981</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">89F80BCE663E7880C8EBF4047C81E12D9D684FBA</idno><idno type="DOI">10.1016/S0002-9149(77)80210-5</idno><idno type="PII">S0002-9149(77)80210-5</idno><idno type="ArticleID">80210</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9149</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">The sequence of antegrade atrial endocardial activation was evaluated in 49 patients: 24 with a normal P wave configuration, 15 with electrocardiographic criteria for left atrial enlargement and 14 with a variety of supraventricular arrhythmias. In 17 patients, 6 with and 11 without evidence of the Wolff-Parkinson-White syndrome, retrograde atrial activation sequence was analyzed during ventricular premature beats, junctional rhythm or supraventricular tachycardia. The recording sites included the high mid- and low right atrium the right atrioventricular (A-V) junction and the distal coronary sinus or the left atrium. In patients with normal P waves atrial activation began at either the high or the mid-right atrium and proceeded to the low right atrium and A-V junction and then the coronary sinus. A similar sequence of activation was noted In patients with left atrial enlargement, but activation at the coronary sinus was markedly delayed (77 ± 8 [mean ± standard deviation] versus 112 ± 14 msec, P <0.001). In 11 patients without preexcitation retrograde activation appeared earliest at the A-V junction then at the coronary sinus and high right atrium. Six patients with the Wolff-Parkinson-White syndrome had normal antegrade atrial activation, and five of the six demonstrated eccentric retrograde atrial activation during supraventricular tachycardia. This study suggests that atrial endocardial mapping is an important diagnostic tool for evaluating supraventricular tachycardias and atrial conduction disturbances.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Mark E. Josephson MD</name><affiliations><json:string>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</json:string></affiliations></json:item><json:item><name>Daniel L. Scharf MD</name><affiliations><json:string>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</json:string></affiliations></json:item><json:item><name>John A. Kastor MD, FACC</name><affiliations><json:string>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</json:string></affiliations></json:item><json:item><name>James G. Kitchen, III MD</name><affiliations><json:string>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</json:string></affiliations></json:item></author><articleId><json:string>80210</json:string></articleId><language><json:string>eng</json:string></language><abstract>The sequence of antegrade atrial endocardial activation was evaluated in 49 patients: 24 with a normal P wave configuration, 15 with electrocardiographic criteria for left atrial enlargement and 14 with a variety of supraventricular arrhythmias. In 17 patients, 6 with and 11 without evidence of the Wolff-Parkinson-White syndrome, retrograde atrial activation sequence was analyzed during ventricular premature beats, junctional rhythm or supraventricular tachycardia. The recording sites included the high mid- and low right atrium the right atrioventricular (A-V) junction and the distal coronary sinus or the left atrium. In patients with normal P waves atrial activation began at either the high or the mid-right atrium and proceeded to the low right atrium and A-V junction and then the coronary sinus. A similar sequence of activation was noted In patients with left atrial enlargement, but activation at the coronary sinus was markedly delayed (77 ± 8 [mean ± standard deviation] versus 112 ± 14 msec, P >0.001). In 11 patients without preexcitation retrograde activation appeared earliest at the A-V junction then at the coronary sinus and high right atrium. Six patients with the Wolff-Parkinson-White syndrome had normal antegrade atrial activation, and five of the six demonstrated eccentric retrograde atrial activation during supraventricular tachycardia. This study suggests that atrial endocardial mapping is an important diagnostic tool for evaluating supraventricular tachycardias and atrial conduction disturbances.</abstract><qualityIndicators><score>7.664</score><pdfVersion>1.3</pdfVersion><pdfPageSize>591 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1534</abstractCharCount><pdfWordCount>5838</pdfWordCount><pdfCharCount>34613</pdfCharCount><pdfPageCount>10</pdfPageCount><abstractWordCount>222</abstractWordCount></qualityIndicators><title>Atrial endocardial activation in man electrode catheter technique for endocardial 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level="a" type="main" xml:lang="en">Atrial endocardial activation in man electrode catheter technique for endocardial mapping</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1977</date></publicationStmt><notesStmt><note>This study was supported in part by Grant HL 14807 from the National Institutes of Health, Bethesda, Maryland, Southeastern Pennsylvania Affiliate of the American Heart Association, Dallas, Texas.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Atrial endocardial activation in man electrode catheter technique for endocardial mapping</title><author><persName><forename type="first">Mark E.</forename><surname>Josephson</surname></persName><roleName type="degree">MD</roleName><note type="biography">Present address: Portsmouth Naval Regional Medical Center, Portsmouth, Virginia.</note><affiliation>Present address: Portsmouth Naval Regional Medical Center, Portsmouth, Virginia.</affiliation><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation></author><author><persName><forename type="first">Daniel L.</forename><surname>Scharf</surname></persName><roleName type="degree">MD</roleName><note type="biography">Present address: The Lankenau Hospital, Lancaster Avenue at City Line, Philadelphia, Pennsylvania.</note><affiliation>Present address: The Lankenau Hospital, Lancaster Avenue at City Line, Philadelphia, Pennsylvania.</affiliation><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation></author><author><persName><forename type="first">John A.</forename><surname>Kastor</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation></author><author><persName><forename type="first">James G.</forename><surname>Kitchen, III</surname></persName><roleName type="degree">MD</roleName><note type="biography">Address for reprints: Mark E, Josephson, MD, 671 White Building, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, Pennsylvania 19104.</note><affiliation>Address for reprints: Mark E, Josephson, MD, 671 White Building, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, Pennsylvania 19104.</affiliation><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(77)X8205-6</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977"></date><biblScope unit="volume">39</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="972">972</biblScope><biblScope unit="page" to="981">981</biblScope></imprint></monogr><idno type="istex">89F80BCE663E7880C8EBF4047C81E12D9D684FBA</idno><idno type="DOI">10.1016/S0002-9149(77)80210-5</idno><idno type="PII">S0002-9149(77)80210-5</idno><idno type="ArticleID">80210</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1977</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>The sequence of antegrade atrial endocardial activation was evaluated in 49 patients: 24 with a normal P wave configuration, 15 with electrocardiographic criteria for left atrial enlargement and 14 with a variety of supraventricular arrhythmias. In 17 patients, 6 with and 11 without evidence of the Wolff-Parkinson-White syndrome, retrograde atrial activation sequence was analyzed during ventricular premature beats, junctional rhythm or supraventricular tachycardia. The recording sites included the high mid- and low right atrium the right atrioventricular (A-V) junction and the distal coronary sinus or the left atrium. In patients with normal P waves atrial activation began at either the high or the mid-right atrium and proceeded to the low right atrium and A-V junction and then the coronary sinus. A similar sequence of activation was noted In patients with left atrial enlargement, but activation at the coronary sinus was markedly delayed (77 ± 8 [mean ± standard deviation] versus 112 ± 14 msec, P <0.001). In 11 patients without preexcitation retrograde activation appeared earliest at the A-V junction then at the coronary sinus and high right atrium. Six patients with the Wolff-Parkinson-White syndrome had normal antegrade atrial activation, and five of the six demonstrated eccentric retrograde atrial activation during supraventricular tachycardia. This study suggests that atrial endocardial mapping is an important diagnostic tool for evaluating supraventricular tachycardias and atrial conduction disturbances.</p></abstract></profileDesc><revisionDesc><change when="1977-01-25">Registration</change><change when="1977-01-18">Modified</change><change when="1977">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier doc found" wicri:toSee="Elsevier, no converted or simple article"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 5.0.1//EN//XML" URI="art501.dtd" name="istex:docType"></istex:docType><istex:document><article version="5.0" xml:lang="en" docsubtype="fla"><item-info><jid>AJC</jid><aid>80210</aid><ce:pii>S0002-9149(77)80210-5</ce:pii><ce:doi>10.1016/S0002-9149(77)80210-5</ce:doi><ce:copyright type="unknown" year="1977">Dun Donnelley Publishing Corporation</ce:copyright></item-info><head><ce:article-footnote><ce:note-para>This study was supported in part by Grant HL 14807 from the National Institutes of Health, Bethesda, Maryland, Southeastern Pennsylvania Affiliate of the American Heart Association, Dallas, Texas.</ce:note-para></ce:article-footnote><ce:title>Atrial endocardial activation in man electrode catheter technique for endocardial mapping</ce:title><ce:author-group><ce:author><ce:given-name>Mark E.</ce:given-name><ce:surname>Josephson</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="cor1"><ce:sup loc="post">a</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Daniel L.</ce:given-name><ce:surname>Scharf</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="cor2"><ce:sup loc="post">*</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>John A.</ce:given-name><ce:surname>Kastor</ce:surname><ce:degrees>MD, FACC</ce:degrees></ce:author><ce:author><ce:given-name>James G.</ce:given-name><ce:surname>Kitchen</ce:surname><ce:suffix>III</ce:suffix><ce:degrees>MD</ce:degrees><ce:cross-ref refid="cor3"><ce:sup loc="post">†</ce:sup></ce:cross-ref></ce:author><ce:affiliation><ce:textfn>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</ce:textfn></ce:affiliation><ce:correspondence id="cor1"><ce:label>*</ce:label><ce:text>Present address: Portsmouth Naval Regional Medical Center, Portsmouth, Virginia.</ce:text></ce:correspondence><ce:correspondence id="cor2"><ce:label>†</ce:label><ce:text>Present address: The Lankenau Hospital, Lancaster Avenue at City Line, Philadelphia, Pennsylvania.</ce:text></ce:correspondence><ce:correspondence id="cor3"><ce:label>a</ce:label><ce:text>Address for reprints: Mark E, Josephson, MD, 671 White Building, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, Pennsylvania 19104.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="7" month="9" year="1976"></ce:date-received><ce:date-revised day="18" month="1" year="1977"></ce:date-revised><ce:date-accepted day="25" month="1" year="1977"></ce:date-accepted><ce:abstract id="ab1" class="author"><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">The sequence of antegrade atrial endocardial activation was evaluated in 49 patients: 24 with a normal P wave configuration, 15 with electrocardiographic criteria for left atrial enlargement and 14 with a variety of supraventricular arrhythmias. In 17 patients, 6 with and 11 without evidence of the Wolff-Parkinson-White syndrome, retrograde atrial activation sequence was analyzed during ventricular premature beats, junctional rhythm or supraventricular tachycardia. The recording sites included the high mid- and low right atrium the right atrioventricular (A-V) junction and the distal coronary sinus or the left atrium. In patients with normal P waves atrial activation began at either the high or the mid-right atrium and proceeded to the low right atrium and A-V junction and then the coronary sinus. A similar sequence of activation was noted In patients with left atrial enlargement, but activation at the coronary sinus was markedly delayed (77 ± 8 [mean ± standard deviation] versus 112 ± 14 msec, <ce:italic>P</ce:italic> <0.001). In 11 patients without preexcitation retrograde activation appeared earliest at the A-V junction then at the coronary sinus and high right atrium. Six patients with the Wolff-Parkinson-White syndrome had normal antegrade atrial activation, and five of the six demonstrated eccentric retrograde atrial activation during supraventricular tachycardia. This study suggests that atrial endocardial mapping is an important diagnostic tool for evaluating supraventricular tachycardias and atrial conduction disturbances.</ce:simple-para></ce:abstract-sec></ce:abstract></head><tail view="all"><ce:bibliography view="all" id="bibliography.0010"><ce:section-title>References</ce:section-title><ce:bibliography-sec id="bibliography-sec.0010"><ce:bib-reference id="bib1"><ce:label>1.</ce:label><sb:reference><sb:contribution langtype="en"><sb:authors><sb:author><ce:given-name>D</ce:given-name><ce:surname>Durrer</ce:surname></sb:author><sb:author><ce:given-name>JP</ce:given-name><ce:surname>Roos</ce:surname></sb:author></sb:authors><sb:title><sb:maintitle>Epicardial excitation of the ventricles In a patient with Wolff-Parkinson-White syndrome (type B)</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>Circulation</sb:maintitle></sb:title><sb:volume-nr>35</sb:volume-nr></sb:series><sb:date>1967</sb:date></sb:issue><sb:pages><sb:first-page>15</sb:first-page><sb:last-page>21</sb:last-page></sb:pages></sb:host></sb:reference></ce:bib-reference><ce:bib-reference id="bib2"><ce:label>2.</ce:label><sb:reference><sb:contribution langtype="en"><sb:authors><sb:author><ce:given-name>AG</ce:given-name><ce:surname>Wallace</ce:surname></sb:author><sb:author><ce:given-name>JP</ce:given-name><ce:surname>Boineau</ce:surname></sb:author><sb:author><ce:given-name>RM</ce:given-name><ce:surname>Davidson</ce:surname></sb:author><sb:et-al></sb:et-al></sb:authors><sb:title><sb:maintitle>Wolff-Parkinson-White syndrome</sb:maintitle></sb:title></sb:contribution><sb:host><sb:issue><sb:series><sb:title><sb:maintitle>A new look. 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lang="en"><title>Atrial endocardial activation in man electrode catheter technique for endocardial mapping</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Atrial endocardial activation in man electrode catheter technique for endocardial mapping</title></titleInfo><name type="personal"><namePart type="given">Mark E.</namePart><namePart type="family">Josephson</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation><description>Present address: Portsmouth Naval Regional Medical Center, Portsmouth, Virginia.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Daniel L.</namePart><namePart type="family">Scharf</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation><description>Present address: The Lankenau Hospital, Lancaster Avenue at City Line, Philadelphia, Pennsylvania.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">John A.</namePart><namePart type="family">Kastor</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">James G.</namePart><namePart type="family">Kitchen, III</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Cardiac Clinical Electrophysiology Laboratory, Hospital of the University of Pennsylvania, and the Cardiovascular Section, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania.</affiliation><description>Address for reprints: Mark E, Josephson, MD, 671 White Building, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, Pennsylvania 19104.</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1977</dateIssued><dateValid encoding="w3cdtf">1977-01-25</dateValid><dateModified encoding="w3cdtf">1977-01-18</dateModified><copyrightDate encoding="w3cdtf">1977</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>The sequence of antegrade atrial endocardial activation was evaluated in 49 patients: 24 with a normal P wave configuration, 15 with electrocardiographic criteria for left atrial enlargement and 14 with a variety of supraventricular arrhythmias. In 17 patients, 6 with and 11 without evidence of the Wolff-Parkinson-White syndrome, retrograde atrial activation sequence was analyzed during ventricular premature beats, junctional rhythm or supraventricular tachycardia. The recording sites included the high mid- and low right atrium the right atrioventricular (A-V) junction and the distal coronary sinus or the left atrium. In patients with normal P waves atrial activation began at either the high or the mid-right atrium and proceeded to the low right atrium and A-V junction and then the coronary sinus. A similar sequence of activation was noted In patients with left atrial enlargement, but activation at the coronary sinus was markedly delayed (77 ± 8 [mean ± standard deviation] versus 112 ± 14 msec, P <0.001). In 11 patients without preexcitation retrograde activation appeared earliest at the A-V junction then at the coronary sinus and high right atrium. Six patients with the Wolff-Parkinson-White syndrome had normal antegrade atrial activation, and five of the six demonstrated eccentric retrograde atrial activation during supraventricular tachycardia. This study suggests that atrial endocardial mapping is an important diagnostic tool for evaluating supraventricular tachycardias and atrial conduction disturbances.</abstract><note>This study was supported in part by Grant HL 14807 from the National Institutes of Health, Bethesda, Maryland, Southeastern Pennsylvania Affiliate of the American Heart Association, Dallas, Texas.</note><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">197706</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(77)X8205-6</identifier><part><detail type="volume"><number>39</number><caption>vol.</caption></detail><detail type="issue"><number>7</number><caption>no.</caption></detail><extent unit="issue pages"><start>939</start><end>1108</end></extent><extent unit="pages"><start>972</start><end>981</end></extent></part></relatedItem><identifier type="istex">89F80BCE663E7880C8EBF4047C81E12D9D684FBA</identifier><identifier type="DOI">10.1016/S0002-9149(77)80210-5</identifier><identifier type="PII">S0002-9149(77)80210-5</identifier><identifier type="ArticleID">80210</identifier><accessCondition type="use and reproduction" contentType="">© 1977Dun Donnelley Publishing Corporation</accessCondition><recordInfo><recordContentSource>ELSEVIER</recordContentSource><recordOrigin>Dun Donnelley Publishing Corporation, ©1977</recordOrigin></recordInfo></mods></metadata><enrichments><istex:catWosTEI uri="https://api.istex.fr/document/89F80BCE663E7880C8EBF4047C81E12D9D684FBA/enrichments/catWos"><teiHeader><profileDesc><textClass><classCode scheme="WOS">CARDIAC & CARDIOVASCULAR SYSTEMS</classCode></textClass></profileDesc></teiHeader></istex:catWosTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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