The intracardiac signals were filtered betweenĥ0-1,OoO Hz. Pacing repeatedly and confirmed its reproducibility. Poor contact of the tissue may lead to erroneous Good contact of the atrial tissue should be required. MA (pulse width: 2.0 ms) at the identical site of Stimulation was done with the output set up to 20 Multiple sites in the RA and CS at least nine sites Intracardiac electrograms were recorded at If it was impossible to place theĬatheter in the CS, an esophageal lead was substituted. The CS, we considered that they were the left atrial If the atrial electrograms could be obtained from Another bipolar catheter (4įrench or 5 French) was inserted via the left subclavian vein and placed in the coronary sinus (CS). While the quadripolar was placed in the rightĪtrium (RA) to record the atrial electrograms, andĪlso for stimulation. Junction to record the His-bundle electrograms, The bipolarĬatheter was placed at the atrioventricular (AV) They ranged in age from 46-80 years, average 62Īt the time of the EPS, a bipolar catheter (5įrench) and a quadripolar catheter (6 French) were (EPS) due to symptomatic bradycardia and wereĭiagnosed as AS, were selected for this study. Had undergone an electrophysiological study Accordingly, we investigated the clinical and electrophysiologicalĮleven patients (7 males and 4 females), who Stimulation, its progression, extent of the lesions,Īnd prognosis are uncertain. Although this disorder can be diagnosed by intracardiac mapping and Thus presumably included both disease forms.Ī precise diagnosis of AS should be based on Not have included a complete mapping study, and Previously reported cases of persistent AS might Received Septemrevision Augaccepted August 30, 1994. School of Medicine, 2-1-1, Hongo, Bunkyo-Ku, Tokyo 113, Levy et aL5 classified AS intoĪddress for reprints: Yuji Nakazato, M.D., Division of Cardiology, Department of Internal Medicine, Juntendo University However, recent advances in intracardiac mapping technique have delineated a more With an absence of electrical and mechanical atrialĪctivity. Persistent atrial standstill (AS) in 1946, this disorder has been recognized as a rare clinical condition Since Chavez et a1.l first reported a case of In the atrioventricular conduction system in patients with A S who had progressive myocarditis or DCM.Ītrial electrograms, intracardiac mapping, myocarditis, dilated cardiomyopathy, prognosis A diffuse and progressive disturbance m a y occur not only in the atrial mus cle, but also Muscular lesion starts in the high lateral R A and progresses toward the lower RA, then to the vicinity of Months, and in another with dilated cardiomyopathy (DCM) it was 8 months. The interval until death in one patient with myocarditis was 6 Patients revealed that the “silent” area spread toward the lower site of RA. A repeated mapping and pacing study conducted in two Vicinity of the tricuspid valve (TV) annulus.
Electrograms were remained present in the When intracardiac mapping was performed, the atrial electrograms tended toĭiminish at the site of high, mid-lateral right atrium (RA). Initially showed A F or Af, and was transformed after several years into ectopic atrial tachycardia or anĮctopic atrial rhythm with a markedly decreased amplitude of the P wave. Noted in 3, atrial fibrillation (Af) in 1, and multifocal atrial tachycardia in 1. In the standard 12-lead ECGs obtained on admission, the P wave was absent in six cases. MajorĬlinical symptoms in the 1 1 cases included Adams-Stokes attacks, and dyspnea on exertion. Underlying heart disease was present in nine patients and two cases were idiopathic.
Males and 4 females), whose average age was 62 years and who were followed over a period of 4-179 The clinical and electrophysiological characteristics of atrial standstill ( A S ) we studied 11 patients (7 NAKAZATO, Y., ET AL.: Clinical and Electrophysiological Characteristics of Atrial Standstill. MASATAKA SUMIYOSHI, SHUNSUKE OGURA, and HIROSHI YAMAGUCHIįrom the Division of Cardiology, Department of Internal Medicine, Juntendo University School YUJI NAKAZATO, YASURO NAKATA, TERUHIKOA HISAOKA,