Tackling an arrhythmia by its mapping and successful ablation demonstrates time and
again the art of integrating function and form—or how the analysis of an arrhythmia
and its successful treatment is essentially linked to its underlying anatomic substrate.
Wilhelm His Jr, after whom the His bundle is named, first described the so-called
“spina vestibuli”—the leading edge of the primary atrial septum, forming the buttress
binding the atrial septum itself to the insulating tissues of the atrioventricular
(AV) junctions.
1
This structure, situated within the center of the heart, is bounded by the aortic
and the AV valves, and is an area requiring abundant caution when ablating locally
because of its proximity to the AV conduction system. However, the anatomy allows
for approaching targets within this area not only from the right atrial (RA) as well
as from the left atrial (LA) side but also from the aortic root,
2
with the aim of avoiding the AV conduction system as well as reaching profoundly
situated arrhythmogenic tissue.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart RhythmAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Wilhelm His Junior and his bundle.J Electrocardiol. 2016; 49: 637-643
- Successful catheter ablation of atrial tachycardia originating near the atrioventricular node from the noncoronary sinus of Valsalva.Pacing Clin Electrophysiol. 2004; 27: 1440-1443
- Focal atrial tachycardias from the parahisian region: strategies for mapping and catheter ablation.Heart Rhythm. 2017; 14: 1344-1350
- Adenosine-sensitive atrial reentrant tachycardia originating from the atrioventricular nodal transitional area.J Cardiovasc Electrophysiol. 1997; 8: 854-864
- Clinical, electrophysiological characteristics, and radiofrequency catheter ablation of atrial tachycardia near the apex of Koch’s triangle.Pacing Clin Electrophysiol. 1998; 21: 367-374
- Catheter ablation of focal atrial tachycardia from the aortic cusp: the role of electroanatomic mapping and intracardiac echocardiography.Pacing Clin Electrophysiol. 2013; 36: e19-e22
- Comparison of strategies for catheter ablation of focal atrial tachycardia originating near the His bundle region.Heart Rhythm. 2017; 14: 998-1005
Article info
Publication history
Published online: June 16, 2017
Identification
Copyright
© 2017 Heart Rhythm Society. All rights reserved.
