Simultaneous epicardial-endocardial mapping of the sinus node in humans with structural heart disease: Impact of overdrive suppression on sinoatrial exits
Ramanathan Parameswaran, Geoffrey Lee, Gwilym M Morris, Alistair Royse, John Goldblatt, Marco Larobina, Troy Watts, Chrishan J Nalliah, Geoffrey Wong, Ahmed M Al-Kaisey, Robert D Anderson, Aleksandr Voskoboinik, Hariharan Sugumar, David Chieng, Prashanthan Sanders, Peter M Kistler, Jonathan M Kalman
Heart Rhythm | ELSEVIER SCIENCE INC | Published : 2020
BACKGROUND: The 3-dimensional (3D) nature of sinoatrial node (SAN) function has not been characterized in the intact human heart. OBJECTIVE: The purpose of this study was to characterize the 3D nature of SAN function in patients with structural heart disease (SHD) using simultaneous endocardial-epicardial (endo-epi) phase mapping. METHODS: Simultaneous intraoperative endo-epi SAN mapping was performed during sinus rhythm at baseline (SRbaseline) and postoverdrive suppression at 600 ms (SRpost-pace600) and 400 ms (SRpost-pace400) using 2 Abbott Advisor HD Grid Mapping Catheters. Unipolar and bipolar electrograms (EGMs) were exported for phase analysis to determine (1) activation exits; (2) wa..View full abstract
Drs Parameswaran, Nalliah, Wong, Anderson, Voskoboinik, Sugumar, and Chieng are supported by the National Health and Medical Research Council (NHMRC) research scholarship. Drs Kalman and Sanders are supported by practitioner fellowships from the NHMRC. Dr Morris is supported by a British Heart Foundation Intermediate Fellowship; has reported receiving research support from Boston Scientific and Medtronic; and has served on the advisory board of Boston Scientific and Biosense Webster. Dr Kalman has reported receiving research support from Biosense Webster, Boston Scientific, Abbott, and Medtronic; and has served on the advisory board of Boston Scientific and Biosense Webster. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.