Atrial Tachycardia Originating from Crista Terminalis

  • C. Pappone
  • G. Oreto
  • M. L. Loricchio
  • S. Bianchi
  • C. D. Dicandia
Conference paper


Atrial tachycardia may be caused by abnormal automaticity, re-entry, or triggered activity. Regardless of the underlying mechanism, it has been observed that, although tachycardia may theoretically arise from any atrial zone, the origin of the arrhythmia is not random, but the ectopic focus or re-entry circuit is frequently located in certain specific areas of the atria [1–4]. It has been suggested that the majority of right atrial tachycardias originate from the crista terminalis (CT) and, accordingly, the term “cristal tachycardia” has been introduced [1–3].


Catheter Ablation Atrial Flutter Sinus Node Atrial Tachycardia Successful Ablation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Lesh MD, Kaiman JM (1996) To fumble flutter or tackle “tach”? Toward updated classifiers for atrial tachyarrhythmias. J Cardiovasc Electrophysiol 7:460–466PubMedCrossRefGoogle Scholar
  2. 2.
    Lesh MD, Kaiman JM, Olgin JE (1997) An electrophysiologic approach to catheter ablation of atrial flutter and tachycardia: from mechanism to practice. In: Singer I (ed) Interventional electrophysiology. Williams and Wilkins, Baltimore, pp 347–382Google Scholar
  3. 3.
    Kaiman JM, Olgin JE, Karch MR, Hamdan M, Lee RJ, Lesh MD (1998) “Cristal tachycardias”: origin of right atrial tachycardia from the crista terminalis identified by intracardiac echocardiography. J Am Coll Cardiol 31:451–459Google Scholar
  4. 4.
    Tada H, Nogami A, Naito S, Suguta M, Nakatsugawa M, Horie Y, Tomita T, Hoshizaki H, Oshima S, Taniguchi K (1998) Simple electrocardiographic criteria for identifying the site of origin of focal right atrial tachycardia. Pacing Clin Electrophysiol 21:2431–2439PubMedCrossRefGoogle Scholar
  5. 5.
    Olgin JE, Kaiman JM, Fitzpatrick AP et al (1995) The role of right endocardial structures as barriers to conduction during human type 1 atrial flutter: activation and entrainment mapping guided by intracardiac echocardiography. Circulation 92:1839–1848PubMedCrossRefGoogle Scholar
  6. 6.
    Boineau JP, Canavan TE, Schuessler RB et al (1988) Demonstration of a widely distributed pacemaker complex in the human heart. Circulation 77:1221–1237PubMedCrossRefGoogle Scholar
  7. 7.
    Kay GN, Chong F, Epstein AE et al (1993) Radiofrequency ablation for treatment of primary atrial tachycardia. J Am Coll Cardiol 21:901–909PubMedCrossRefGoogle Scholar
  8. 8.
    Walsh EP, Saul JP, Huise JE et al (1992) Transcatheter ablation of ectopic atrial tachycardia in young patients using radiofrequency current. Circulation 86:1138–1146PubMedCrossRefGoogle Scholar
  9. 9.
    Shenasa H, Merril JJ, Hamer ME, Wharton JM (1993) Distribution of ectopic atrial tachycardias along the crista terminalis: an atrial ring of fire? Circulation 88 [Suppl I]:I–29 (abstr)Google Scholar
  10. 10.
    Sanders WE Jr, Sorrentino RA, Greenfield RA et al (1994) Catheter ablation of sinus node reentrant tachycardia. J Am Coll Cardiol 23:926–934PubMedCrossRefGoogle Scholar
  11. 11.
    Pappone C, Stabile G, De Simone A et al (1996) Role of catheter-induced mechanical trauma in localizing of target sites of radiofrequency ablation in automatic atrial tachycardia. J Am Coll Cardiol 27:1090–1097PubMedCrossRefGoogle Scholar
  12. 12.
    Saffitz JE, Kanter HL, Green KG et al (1994) Tissue-specific determinants of anisotropic conduction velocity in canine atrial and ventricular myocardium. Circ Res 74:1065–1070PubMedCrossRefGoogle Scholar
  13. 13.
    Joyner R, Van Capelle F (1986) Propagation through electrically coupled cells: how a small SA node drives a large atrium. Biophys J 50:1157–1164PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2000

Authors and Affiliations

  • C. Pappone
    • 1
  • G. Oreto
    • 2
  • M. L. Loricchio
    • 1
  • S. Bianchi
    • 1
  • C. D. Dicandia
    • 1
  1. 1.Dipartimento di CardiologiaOspedale S. RaffaeleMilanItaly
  2. 2.Dipartimento di CardiologiaUniversità di MessinaItaly

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