TL;DR: In this article, activation and entrainment mapping, guided by intracardiac echocardiography (ICE), was used to determine whether the crista terminalis (CT) and eustachian ridge (ER) are barriers to conduction during typical atrial flutter in humans.
Abstract: Background The importance of barriers in atrial flutter has been demonstrated in animals. We used activation and entrainment mapping, guided by intracardiac echocardiography (ICE), to determine whether the crista terminalis (CT) and eustachian ridge (ER) are barriers to conduction during typical atrial flutter in humans. Methods and Results In eight patients, ICE was used to guide the placement of 20-pole and octapolar catheters along the CT and interatrial septum and a roving catheter to nine sites: just posterior (1) and anterior (2) to the CT along the lateral right atrium, at the fossa ovalis (3), and just posterior and anterior to the ER at the low posterolateral (4 and 5), low posterior (6 and 7), and low posteromedial (8 and 9) right atrium. Entrainment was performed, and each site was considered within the flutter circuit if the postpacing interval–flutter cycle length (PPI−FCL) and the stimulus time–activation time (stim time−act time) were <10 msec. Split potentials were recorded along the CT wi...
TL;DR: In this paper, an apparatus for facilitating access to the left atrium, and specifically the atrial appendage, is described, which may include a sheath with first and second curved sections that facilitate location of the fossa ovalis and left atrial appendix.
Abstract: Disclosed is an apparatus for facilitating access to the left atrium, and specifically the left atrial appendage. The apparatus may comprise a sheath with first and second curved sections that facilitate location of the fossa ovalis and left atrial appendage. The apparatus may further comprise tissue piercing and dilating structures. Methods are also disclosed.
TL;DR: Sixteen aneurysms of the septum primum were found at autopsy among 1,578 adults; most occurred in individuals in their fifth or sixth decade and most seemed associated with normal intra-atrial pressures.
Abstract: Sixteen aneurysms of the septum primum were found at autopsy among 1,578 adults. Most occurred in individuals in their fifth or sixth decade. All aneurysms were asymptomatic and none were diagnosed before death. Fourteen bulged into the right ventricle. The aneurysm may develop in patients with a raised intra-atrial pressure but most seemed associated with normal intra-atrial pressures. A particular morphology of the fossa ovalis region may predispose the septum to aneurysm formation. Echocardiographic and angiographic features of the aneurysm need definition to distinguish them from those caused by other lesions.
TL;DR: In this paper, the authors used multislice CT (MSCT) to diagnose Lipomatous hypertrophy of the interatrial septum (LHIS) in elderly, obese patients and may cause arrhythmia.
TL;DR: A new method for the measurement of left atrial pressure in man was described, in 13 patients the interatrial septum was punctured by means of a flexible needle passed through a cardiac catheter which had been introduced from the saphenous vein.
Abstract: A new method for the measurement of left atrial pressure in man is described. In 13 patients the interatrial septum was punctured by means of a flexible needle passed through a cardiac catheter which had been introduced from the saphenous vein and positioned with its tip against the fossa ovalis. No complications were observed after the procedures. The advantages of the technique and its present and projected usefulness are discussed.