{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:33Z","timestamp":1753876233048,"version":"3.41.2"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":13,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Perimitral flutter (PMF) is a macro-reentrant tachycardia, and mitral isthmus (MI) linear ablation is considered to be the preferable mode of treatment. Additionally, PMF can sometimes develop via epicardial connections, including coronary sinus and vein of Marshall. However, there are no reports of three-dimensional (3D) atrial tachycardia (AT) via the intramural tissue.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 78-year-old man underwent catheter ablation for paroxysmal atrial fibrillation and AT, including pulmonary vein isolation, left atrial posterior wall isolation, superior vena cava isolation, and MI linear ablation in a total of four procedures. However, AT reoccurred, and he underwent a 5th procedure for AT. Although the MI block line was complete in both the endocardial and epicardial voltage maps, AT indicated PMF. The total activation time did not cover all phases of tachycardia cycle length due to the conduction pathway through the intramural muscle\/bundles that could not be mapped with the addition of epicardial mapping. The tachycardia was terminated by ablation at the mitral valve annulus in the 2 o\u2019clock position, where the bundles might have been attached.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Both endocardial and epicardial activation maps indicated 3D-PMF, whose circuit included the intramural muscle and bundles in a tachycardia circuit. It is necessary to recognize AT, which is involved via intramural tissues.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab411","type":"journal-article","created":{"date-parts":[[2021,10,18]],"date-time":"2021-10-18T11:51:34Z","timestamp":1634557894000},"source":"Crossref","is-referenced-by-count":0,"title":["Endocardial and epicardial activation maps for three-dimensional perimitral flutter using a three-dimensional mapping system: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9564-3655","authenticated-orcid":false,"given":"Tomoyuki","family":"Arai","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10, Ebisu, Shibuya-ku, Tokyo 150-0013, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masao","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10, Ebisu, Shibuya-ku, Tokyo 150-0013, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6332-2355","authenticated-orcid":false,"given":"Rintaro","family":"Hojo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10, Ebisu, Shibuya-ku, Tokyo 150-0013, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0291-9702","authenticated-orcid":false,"given":"Seiji","family":"Fukamizu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Metropolitan Hiroo Hospital, 2-34-10, Ebisu, Shibuya-ku, Tokyo 150-0013, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"2021103110200718700_ytab411-B1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1111\/pace.13640","article-title":"Importance of the vein of Marshall involvement in mitral isthmus ablation","volume":"42","author":"Fujisawa","year":"2019","journal-title":"Pacing Clin Electrophysiol"},{"key":"2021103110200718700_ytab411-B2","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/j.hrcr.2015.03.012","article-title":"Pseudo-conduction block at the mitral isthmus in a patient with epicardial impulse propagation through the vein of Marshall","volume":"1","author":"Hojo","year":"2015","journal-title":"HeartRhythm Case Rep"},{"key":"2021103110200718700_ytab411-B3","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1016\/j.jacep.2020.09.022","article-title":"Indirect and direct evidence for 3-D activation during left atrial flutter: anatomy of epicardial bridging","volume":"6","author":"Nayak","year":"2020","journal-title":"JACC Clin Electrophysiol"},{"key":"2021103110200718700_ytab411-B4","doi-asserted-by":"crossref","first-page":"884","DOI":"10.1016\/j.jacc.2019.12.044","article-title":"Simultaneous endocardial and epicardial delineation of 3D reentrant ventricular tachycardia","volume":"75","author":"Tung","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2021103110200718700_ytab411-B5","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1111\/jce.14079","article-title":"Achieving durable mitral isthmus block: challenges, pitfalls, and methods of assessment","volume":"30","author":"Hamoud","year":"2019","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2021103110200718700_ytab411-B6","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1093\/eurheartj\/ehm606","article-title":"The architecture of the left lateral atrial wall: a particular anatomic region with implications for ablation of atrial fibrillation","volume":"29","author":"Cabrera","year":"2008","journal-title":"Eur Heart J"},{"key":"2021103110200718700_ytab411-B7","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.hrthm.2020.11.008","article-title":"Epicardial course of the septopulmonary bundle: anatomical considerations and clinical implications for roof line completion","volume":"18","author":"Pambrun","year":"2021","journal-title":"Heart Rhythm"}],"container-title":["European Heart Journal - 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