Atrial anatomy and imaging in atrial fibrillation ablation

Journal of Cardiovascular Electrophysiology

Volumn 17, Issue SUPPL. 3, 2006, Pages

  McGavigan, Andrew D ^a   Kalman, Jonathan M ^a,b  

^a ROYAL MELBOURNE HOSPITAL   (Australia)

^b UNIVERSITY OF MELBOURNE   (Australia)

Author keywords

Anatomy; Atrial fibrillation; Catheter ablation; Computerized tomography; Imaging; Intracardiac echocardiography; Magnetic resonance imaging

Indexed keywords

CATHETER ABLATION; COMPUTER ASSISTED TOMOGRAPHY; CONFERENCE PAPER; ECHOCARDIOGRAPHY; ESOPHAGUS FISTULA; EXPERIMENTAL MODEL; HEART ATRIUM FIBRILLATION; HEART LEFT ATRIUM; HEART RIGHT ATRIUM; HUMAN; IMAGING; NONHUMAN; NUCLEAR MAGNETIC RESONANCE IMAGING; PHLEBOGRAPHY; PRIORITY JOURNAL; PULMONARY VEIN;

EID: 33751170194     PISSN: 10453873     EISSN: 15408167     Source Type: Journal    
DOI: 10.1111/j.1540-8167.2006.00627.x     Document Type: Conference Paper

References (93)

1. Swartz JF, Perrersels G, Silvers J, Patten L, Cervantez D: A catheter based curative approach to atrial fibrillation in humans. Circulation 1994;90(Suppl 1):I-335.
2. Oral H, Knight BP, Tada H, Ozaydin M, Chugh A, Hassan S, Scharf C, Lai SW, Greenstein R, Pelosi F, Strickberger SA, Morady F: Pulmonary vein isolation for paroxysmal and persistent atrial fibrillation. Circulation 2002;105:1077-1081.
3. Macle L, Jais P, Scavee C, Weerasooriya R, Shah DC, Hocini M, Choi KJ, Raybaud F, Clementt J, Haissaguerre M: Electrophysiologically guided pulmonary vein isolation during sustained atrial fibrillation. J Cardiovasc Electrophysiol 2003;14:255-260.
4. Pappone C, Rosanio S, Oreto G, Tocchi M, Gugliotta F, Vicedomini G, Salvati A, Dicandia C, Mazzone P, Santinelli V, Gulletta S, Chierchia S: Circumferential radiofrequency ablation of pulmonary vein ostia: A new anatomic approach for curing atrial fibrillation. Circulation 2000;102:2619-2628.
5. Ouyang F, Bansch D, Ernst S, Schaumann A, Hachiya H, Chen M, Chun J, Falk P, Khanedani A, Antz M, Kuck KH: Complete isolation of left atrium surrounding the pulmonary veins: New insights from the double-Lasso technique in paroxysmal atrial fibrillation. Circulation 2004;110:2090-2096.
6. Lemola K, Oral H, Chugh A, Hall B, Cheung P, Han J, Tamirisa K, Good E, Bogun F, Pelosi F, Morady F: Pulmonary vein isolation as an end point for left atrial circumferential ablation of atrial fibrillation. J Am Coll Cardiol 2005;46:1060-1066.
7. Jais P, Hocini M, Hsu LF, Sanders P, Scavee C, Weerasooriya R, Macle L, Raybaud F, Garrigue S, Shah DC, Le Metayer P, Clementy J, Haissaguerre M: Technique and results of linear ablation at the mitral isthmus. Circulation 2004;110:2996-3002.
8. Oral H, Chugh A, Good E, Igic P, Elmouchi D, Tschopp DR, Reich SS, Bogun F, Pelosi F, Morady F: Randomized comparison of encircling and non-encircling left atrial ablation for chronic atrial fibrillation. Heart Rhythm 2005;2:1165-1172.
9. Nademanee K, McKenzie J, Kosar E, Schwab M, Sunsaneewitayakul B, Vasavakul T, Khunnawat C, Ngarmukos T: A new approach for catheter ablation of atrial fibrillation: Mapping of the electrophysiologic substrate. J Am Coll Cardiol 2004;43:2054-2056.
10. Oral H, Chugh A, Lemola K, Cheung P, Hall B, Good E, Han J, Tamirisa K, Bogun F, Pelosi F, Morady F: Non-inducibility of atrial fibrillation as an end point of left atrial circumferential ablation for paroxysmal atrial fibrillation: A randomized study. Circulation 2004;110:2797-2801.
11. Pappone C, Santinelli V, Manguso F, Vicedomini G, Gugliotta F, Augello G, Mazzone P Tortoriello V, Landoni G, Zangrillo A, Lang CC, Tomita T, Mesas C, Mastella E, Alfieri O: Pulmonary vein denervation enhances long-term benefit after circumferential ablation for paroxysmal atrial fibrillation. Circulation 2004;109:327-334.
12. Lin YJ, Tai CT, Kao T, Tso HW, Huang JL, Higa S, Yuniadi Y, Huang BH, Liu TY, Lee PC, Hsieh MH, Chen SA: Electrophysiologic characteristics and catheter ablation in patients with paroxysmal right atrial fibrillation. Circulation 2005;112:1692-1700.
13. Anderson RH, Brown NA: Anatomy of the heart revisited. Anat Rec 1996;246:1-7.
14. Anderson RH, Brown NA, Webb S: Development and structure of the atrial septum. Heart 2002;88:104-110.
15. Mitchel JF, Gillam LD, Sanzorbino BW, Hirst JA, McKay RG: Intracardiac ultrasound imaging during transseptal catheterization. Chest 1995;108:104-108.
16. Epstein LM, Smith T, Tenhoff H: Nonfluoroscopic transseptal catheterization: Safety and efficacy of intracardiac echocardiographic guidance. J Cardiovasc Electrophysiol 1998;9:625-630.
17. Daoud E, Kalbfleisch S, Hummel J: Intracardiac echocardiography to guide transseptal left heart catheterization for radiofrequency catheter ablation. J Cardiovasc Electrophysiol 1999;10:358-363.
18. Johnson SB, Seward JB, Packer D: Phased-array intracardiac echocardiography for guiding transseptal catheter placement: Utility and learning curve. Pacing Clin Electrophysiol 2002;25:402-407.
19. Verma A, Marrouche N, Natale A: Pulmonary vein antrum isolation: Intracardiac echocardiography-guided technique. J Cardiovasc Electrophysiol 2004;15:1335-1340.
20. Haissaguerre M, Jais P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Matayer P, Clementy J: Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 1998;339:659-666.
21. Jais P, Haissaguerre M, Shah DC, Chouairi S, Gencel L, Hocini M, Clementy J: A focal source of atrial fibrillation treated by discrete radiofrequency ablation. Circulation 1997;95:572-576.
22. Burch GE, Romney RB: Functional anatomy and "throttle valve" action of the pulmonary veins. Am Heart J 1954;47:58-66.
23. Nathan H, Eliakim M: The junction between the left atrium and the pulmonary veins. An anatomic study of human hearts. Circulation 1966;34:412-422.
24. Ho SY, Sanchez-Quintana D, Cabrera JA, Anderson RH: Anatomy of the left atrium: Implications for radiofrequency ablation of atrial fibrillation. J Cardiovasc Electrophysiol 1999;10:1525-1533.
25. Ho SY, Cabrera JA, Tran VH, Farre J, Anderson RH, Sanchez-Quintana D: Architecture of the pulmonary veins: Relevance to radiofrequency ablation. Heart 2001;86:265-270.
26. Fynn SP, Kalman JM: Pulmonary veins: Anatomy, electrophysiology, tachycardia and fibrillation. Pacing Clin Electrophysiol 2004;27:1547-1559.
27. Robbins IM, Colvin EV, Doyle TP, Kemp WE, Loyd JE, McMahon WS, Kay GN: Pulmonary vein stenosis after catheter ablation of focal atrial fibrillation. Circulation 1998;98:1769-1775.
28. Scanavacca M, Kajita LJ, Vieira M, Sosa EA: Pulmonary vein stenosis complicating catheter ablation of focal atrial fibrillation. J Cardiovasc Electrophysiol 2000;11:677-681.
29. Verma A, Kilicaslan F, Pisano E, Marrouche NF, Fanelli R, Brachmann J, Geunther J, Potenza D, Martin DO, Cummings J, Burkhardt JD, Saliba W, Schweikert RA, Natale A: Response of atrial fibrillation to pulmonary vein antrum isolation is directly related to resumption and delay of pulmonary vein conduction. Circulation 2005;112:627-635.
30. Morton JB, Sanders P, Byrne JG, Power J, Mow C, Edwrads GA, Kalman JM: Phased-array intracardiac echocardiography to guide radiofrequency ablation in the left atrium and at the pulmonary vein ostium. J Cardiovasc Electrophysiol 2001;12:343-348.
31. Mangrum JM, Mounsey JP, Kok LC, DiMarco JP, Haines DE: Intracardiac echocardiography-guided, anatomically based radiofrequency ablation of focal atrial fibrillation originating from pulmonary veins. J Am Coll Cardiol 2002;39:1964-1972.
32. Marrouche N, Martin DO, Wazni O, Gillinov AM, Klein A, Bhargava M, Saad E, Bash D, Yamada H, Jaber W, Schweikert R, Tchou P, Abdul-Karim A, Saliba W, Natale A: Phased-array intracardiac echocardiography monitoring during pulmonary vein isolation in patients with atrial fibrillation: Impact on outcome and complications. Circulation 2003;107:2710-2716.
33. Kato R, Lickfett L, Meininger GR, Dickfeld T, Wu R, Juang G, Angkeow P, LaCorte J, Bluemke D, Berger R, Halperin HR, Calkins H: Pulmonary vein anatomy in patients undergoing catheter ablation of atrial fibrillation. Circulation 2003;107:2004-2010.
34. Marom EM, Herndon JE, Kim YH, McAdans HP: Variations in pulmonary venous drainage to the left atrium: Implications for radiofrequency ablation. Radiology 2004;230:824-829.
35. Lin WS, Prakash V, Tai CT, Hsieh MH, Tsai CF, Yu WC, Lin YK, Ding YA, Chang MS, Chen SA: Pulmonary vein morphology in patients with paroxysmal atrial fibrillation initiated by ectopic beats originating from pulmonary veins: Implications for electrophysiologic characteristics and catheter ablation. Circulation 2000;101:1274-1281.
36. Mikaelian BJ, Malchano ZJ, Neuzil P, Weichet J, Doshi SK, Ruskin JN, Reddy VY: Integration of 3-dimensional cardiac computed tomography images with real-time electroanatomic mapping to guide catheter ablation of atrial fibrillation. Circulation 2005;112:e35-e36.
37. Tops LF, Bax JJ, Zeppenfeld K, Jongbloed MR, Lamb HJ, van der Wall EE, Schalij MJ: Fusion of multislice computed tomography imaging with three-dimensional electroanatomic mapping to guide radiofrequency catheter ablation procedures. Heart Rhythm 2005;2:1076-1081.
38. Dong J, Dickfield T, Lamiy SZ, Calkins H: Catheter ablation of atrial fibrillation guided by registered computed tomographic image of the atrium. Heart Rhythm 2005;2:1021-1022.
39. Novak PG, Macle L, Thibault B, Guerra PG: Enhanced left atrial mapping using digitally synchronized NavX three-dimensional nonfluoroscopic mapping and high-resolution computed tomographic imaging for catheter ablation of atrial fibrillation. Heart Rhythm 2005;1:521-522.
40. Dong J, Calkins H, Solomon SB, Lai S, Dalal D, Lardo A, Brem E, Preiss A, Berger RD, Halperin H, Dickfeld T: Integrated electroanatomic mapping with three-dimensional computed tomographic images for real time guided ablations. Circulation 2006;113:186-194.
41. Dong J, Dickfeld TM, Dalal D, Cheema A, Vasamreddy CR, Henrikson CA, Marine JE, Halperin HR, Berger RD, Lima J, Bluemke DA, Calkins H: Initial experiences in the use of integrated electroanatomic mapping with three dimensional MR/CT images to guide catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol (in press).
42. Reddy VY, Malchano ZJ, Neuzil P, Cury RC, Holmvang G, Weichet J, Schmidt EJ, Ruskin JN: Integration of cardiac CT/MR imaging with 3-dimensional electroanatomical mapping to guide catheter manipulation in the left atrium: Implications for catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol (in press).
43. Wood MA, Wittkampf FH, Henry D, Martin R, Nixon JV, Shepard RK, Ellenbogen KA: A comparison of pulmonary vein ostial anatomy by computerized tomography, echocardiography and venography in patients with atrial fibrillation having radiofrequency catheter ablation. Am J Cardiol 2004;93:49-53.
44. Wittkampf FH, Vonken EJ, Derksen B, Loh P, Velthuis B, Wever EF, Boersma LV, Rensing BJ, Cramer MJ: Pulmonary vein ostial geometry analysis by magnetic resonance angiography. Circulation 2003;107:21-23.
45. Jongbloed MR, Bax JJ, Lamb HJ, Dirksen MS, Zeppenfekd K, van der Wall EE, de Roos A, Schalij MJ: Multislice computed tomography versus intracardiac echocardiography to evaluate the pulmonary veins before radiofrequency catheter ablation of atrial fibrillation: A head-to-head comparison. J Am Coll Cardiol 2005;45:343-350.
46. Lickfett L, Dickfeld T, Kato R, Tandri H, Vasmreddy CR, Berger R, Bluemke D, Luderitz B, Halperin H, Calkins H: Changes of pulmonary vein orifice size and location throughout the cardiac cycle: Dynamic analysis using magnetic resonance cine imaging. J Cardiovasc Electrophysiol 2005;16:582-588.
47. Noseworthy PA, Malchano ZJ, Ahmed J, Homvang G, Ruskin JN, Reddy VY: The impact of respiration on left atrial and pulmonary venous anatomy: Implications for image-guided intervention. Heart Rhythm 2005;2:1173-1178.
48. Chu E, Kalman JM, Kwasman MA, Jue JC, Fitzgerald PJ, Epstein LM, Schiller NB, Yock PG, Lesh MD: Intracardiac echocardiography during radiofrequency catheter ablation of cardiac arrhythmias in humans. J Am Coll Cardiol 1994;24:1351-1357.
49. Kalman JM, Fitzpatrick A, Olgin JE, Chin MC, Lee RJ, Scheinman MM, Lesh MD: Biophysical characteristics of radiofrequency lesion formation in vivo: Dynamics of catheter tip-tissue contact evaluated by intracardiac echocardiography. Am Heart J 1997;133:8-18.
50. Ernst S, Ouyang F, Linder C, Hertting K, Stahl F, Chun J, Hachiya H, Bansch D, Antz M, Kuck KH: Initial experience with remote catheter ablation using a novel magnetic navigation system: Magnetic remote catheter ablation. Circulation 2004;109:1472-1475.
51. Ernst S, Hachiya H, Chun JK, Ouyang F: Remote catheter ablation of parahisian accessory pathways using a novel magnetic navigation system - a report of two cases. J Cardiovasc Electrophysiol 2005;16:659-662.
52. Jais P, Shah DC, Haissaguerre M, Takahashi A, Lavergne T, Hocini M, Garrigue S, Barold SS, Le Metayer P, Clementy J: Efficacy and safety of septal and left atrial linear ablation for atrial fibrillation. Am J Cardiol 1999;84:139-146.
53. Ernst S, Ouyang F, Lober F, Antz M, Kuck KH: Catheter-induced linear lesions in the left atrium in patients with atrial fibrillation. J Am Coll Cardiol 2003;42:1271-1282.
54. Oral H, Scharf C, Chugh A, Hall B, Cheung P, Good E, Veerareddy S, Pelosi F, Morady F: Catheter ablation for paroxysmal atrial fibrillation: Segmental pulmonary vein ablation versus left atrial ablation. Circulation 2003;108:2355-2360.
55. Becker A: Left atrial isthmus: Anatomic aspects relevant for linear catheter ablation procedures in humans. J Cardiovasc Electrophysiol 2004;15:809-812.
56. Wittkampf FH, van Oosterhout MFM, Loh P, Derksen R, Vonken EJ, Slootweg PJ, Ho SY: Where to draw the mitral isthmus line in catheter ablation of atrial fibrillation: Histological analysis. Eur Heart J 2005;26:689-695.
57. Jais P, Shah DC, Haissaguerre M, Hocini M, Peng JT, Takahashi A, Garrigue S, Le Metayer P, Clementy J: Mapping and ablation of left atrial flutters. Circulation 2000;101:2928-2934.
58. Ouyang F, Ernst S, Vogtmann T, Goya M, Volkmer M, Schaumann A, Antz M, Kuck KH: Characterization of reentrant circuits in left atrial macro-reentrant tachycardia: Critical isthmus block can prevent atrial tachycardia recurrence. Circulation 2002;105:1934-1942.
59. Villacastin J, Perez-Castellano N, Moreno J, Gonzales R: Left atrial flutter after radiofrequency catheter ablation of focal atrial fibrillation. J Cardiovasc Electrophysiol 2003;14:417-421.
60. Ludinghausen VM, Ohmachi N, Boot C: Myocardial coverage of the coronary sinus and related veins. Clin Anat 1992;5:1-15.
61. Fuller IA, Wood MA: Intramural coronary vasculature prevents transmural radiofrequency lesion formation: Implications for linear ablation. Circulation 2003;107:1797-1803.
62. Chauvin M, Shah DC, Haissaguerre M, Marcellin L, Brechenmacher C: The anatomic basis of connections between the coronary sinus musculature and the left atrium in humans. Circulation 2000;101:647-652.
63. Epstein LM, Mitchell MA, Smith TW, Haines DE: Comparative study of fluoroscopy and intracardiac echocardiographic guidance for the creation of linear atrial lesions. Circulation 1998;98:1796-1801.
64. Olgin JE, Kalman JM, Chin M, Stillson C, Maguire M, Ursel P, Lesh MD: Electrophysiological effects of long, linear atrial lesions placed under intracardiac ultrasound guidance. Circulation 1997;96:2715-2721.
65. Maleki K, Mohammadi R, Hart D, Cotiga D, Farhat N, Steinberg JS: Intracardiac ultrasound detection of thrombus on transseptal sheath: Incidence, treatment and prevention. J Cardiovasc Electrophysiol 2005;16:561-565.
66. Scanavacca M, d'Avila A, Parga J, Sossa E: Left atrial-esophageal fistula following radiofrequency catheter ablation of atrial fibrillation. J Cardiovasc Electrophysiol 2004;15:960-962.
67. Pappone C, Oral H, Santinelli V, Vicedomini G, Lang CC, Manguso F, Torracca L, Benussi S, Alfieri O, Hong R, Lau W, Hirata K, Shikuma N, Hall B, Morady F: Atrio-esophageal fistula as a complication of percutaneous transcatheter ablation of atrial fibrillation. Circulation 2004;109:2724-2726.
68. Sanchez-Quintana D, Cabrera JA, Climent V, Farre J, de Medonca MC, Ho SY: Anatomic relations between the esophagus and left atrium and relevance for ablation of atrial fibrillation. Circulation 2005;112:1400-1405.
69. Lemola K, Sneider M, Desjardins B, Case I, Han J, Good E, Tamirisa K, Tsemo A, Chugh A, Bogun F, Pelosi F, Kazerooni E, Morady F, Oral H: Computed tomographic analysis of the anatomy of the left atrium and the esophagus: Implications for left atrial catheter ablation. Circulation 2004;110:3655-3660.
70. Kottkamp H, Piorkowski C, Tanner H, Kobza R, Dorszewski A, Shirdewahn P, Gerds-Li JH, Hindricks G: Topographic variability of the esophageal left atrial relation influencing ablation lines in patients with atrial fibrillation. J Cardiovasc Electrophysiol 2005;16:146-150.
71. Han J, Good E, Morady F, Oral H: Esophageal migration during left atrial catheter ablation for atrial fibrillation. Circulation 2004;110:e528.
72. Dickfeld TM, Calkins H, Zviman M, Kato R, Meininger G, Lickfett L, Berger R, Halperin H, Solomon SB: Anatomic stereotactic catheter ablation on three-dimensional magnetic resonance images in real time. Circulation 2003;108:2407-2413.
73. Ferguson JD, Helms AS, Hummel JP: Real-time intracardiac ultrasound imaging of the ablation catheters relation to the esophagus during left atrial ablation. Circulation 2005;112:II-555.
74. Natale A, Leonelli F, Beheiry S, Newby K, Pisano E, Potenza D, Rajkovich K, Wides B, Cromwell L, Tomassoni G: Catheter ablation approach on the right side only for management of patients with refractory atrial fibrillation. Pacing Clin Electrophysiol 2000;23:224-233.
75. Sanders P, Berenfeld O, Hocini M, Jais P, Vaidyanathan R, Hsu LF, Garrigue S, Takahashi Y, Rotter M, Sacher F, Scavee C, Ploutz-Snyder R, Jalife J, Haissaguerre M: Spectral analysis identifies sites of high-frequency activity maintaining atrial fibrillation in humans. Circulation 2005;112:789-797.
76. Saffitz JE, Kanter HL, Green KG, Tolley TK, Beyer EC: Tissue-specific determinants of anisotropic conduction velocity in canine atrial and ventricular myocardium. Circ Res 1994;74:1065-1070.
77. Sanchez-Quintana D, Anderson RH, Cabrera JA, Climent V, Martin R, Farre J, Ho SY: The terminal crest: Morphological features relevant to electrophysiology. Heart 2002;88:325-327.
78. Kalman JM, Olgin JE, Karch M, Hamdan M, Lee RJ, Lesh MD: "Cristal tachycardias": Origin of right atrial tachycardias from the crista terminalis identified by intracardiac echocardiography. J Am Coll Cardiol 1998;31:451-459.
79. Fynn SP, Morton JB, Deen VR, Kistler PM, Vohra JK, Sparks PB, Kalman JM: Conduction characteristics at the crista terminalis during onset of pulmonary vein atrial fibrillation. J Cardiovasc Electrophysiol 2004;15:855-861.
80. Marchlinski F, Ren JF, Schwartzman D, Callans DJ, Gottlieb CD: Accuracy of fluoroscopic localization of the Crista terminalis documented by intracardiac echocardiography. J Interv Card Electrophysiol 2000;4:415-421.
81. Lesh MD, Kalman JM, Karch M: Use of intracardiac echocardiography during electrophysiologic evaluation and therapy of atrial arrhythmias. J Cardiovasc Electrophysiol 1998;9:S40-S47.
82. Antz M, Otomo K, Arruda M, Scherlag BJ, Pitha J, Tondo C, Lazzara R, Jackman WM: Electrical conduction between the right atrium and the left atrium via the musculature of the coronary sinus. Circulation 1998;98:1790-1795.
83. Tsai CF, Tai CT, Hsieh MH, Lin WS, Yu WC, Ueng KC, Ding YA, Chang MS, Chen SA: Initiation of atrial fibrillation by ectopic beats originating within the superior caval vein. Circulation 2000;102:67-74.
84. Lin WS, Tai CT, Hsieh MH, Tsai CF, Lin YK, Tsao HM, Huang JL, Yu WC, Yang SP, Ding YA, Chang MS, Chen SA: Catheter ablation of paroxysmal atrial fibrillation initiated by non-pulmonary vein ectopy. Circulation 2003;107:3176-3183.
85. Hashizume H, Ushiki T, Ahe K: A histological study of the cardiac muscle of the human superior and inferior venae cavae. Arch Histol Cytol 1995;58:457-464.
86. Kholova I, Kautzner J: Morphology of atrial myocardial extensions into human caval veins: A postmortem study in patients with and without atrial fibrillation. Circulation 2004;110:483-488.
87. Huang BH, Wu MH, Tsao HM, Tai CT, Lee KT, Lin YJ, Hsieh MH, Lee SH, Chen YJ, Kuo YJ, Chen SA: Morphology of the thoracic veins and left atrium in paroxysmal atrial fibrillation initiated by superior vena caval ectopy. J Cardiovasc Electrophysiol 2005;16:411-417.
88. Callans DJ, Ren JF, Schwartzman D, Gottlieb CD, Chaudhry FA, Marchlinski FE: Narrowing of the superior vena cava-right atrium junction during radiofrequency catheter ablation for inappropriate sinus tachycardia: Analysis with intracardiac echocardiography. J Am Coll Cardiol 1999;33:1667-1670.
89. Kalman JM, Lee RJ, Fisher WG, Chin MC, Ursell P, Stillson CA Lesh MD, Scheinman MM: Radiofrequency catheter modification of sinus pacemaker function guided by intracardiac echocardiography. Circulation 1995;92:3070-3081.
90. Cabrera JA, Sanchez-Quintana D, Ho SY, Medina A, Wanguemert F, Gross E, Grillo J, Hernandez E, Anderson RH: The architecture of the atrial musculature between the orifice of the inferior caval vein and the tricuspid valve: The anatomy of the isthmus. J Cardiovasc Electrophysiol 1998;9:1186-1195.
91. Cabrera JA, Sanchez-Quintana D, Farre J, Rubio JM, Ho SY: The inferior right atrial isthmus: Further architectural insights for current and coming ablation technologies. J Cardiovasc Electrophysiol 2005;16:402-408.
92. Olgin JE, Kalman JM, Fitzpatrick A, Lesh MD: Role of right atrial endocardial structures as barriers to conduction during human type I atrial flutter: Activation and entrainment mapping guided by intracardiac echocardiography. Circulation 1995;92:1839-1848.
93. Morton JB, Sanders P, Davidson NC, Sparks PB, Vohra JK, Kalman JM: Phased-array intracardiac echocardiography for defining cavotricuspid isthmus anatomy during radiofrequency ablation of typical atrial flutter. J Cardiovasc Electrophysiol 2003;14:591-597.