{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T20:10:38Z","timestamp":1784837438693,"version":"3.55.0"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intra-isthmus re-entry, in which the tachycardia circuit is localized within the cavotricuspid isthmus region and the coronary sinus ostium, has been reported as an atypical form of atrial tachycardia. It has been delineated by three-dimensional mapping as either macro-re-entrant type around the cavotricuspid isthmus and coronary sinus area (but with the coexistence of typical atrial flutter), or focal type from the cavotricuspid isthmus area.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We present the first reported case of an apparently new form of macro-re-entrant intra-isthmus re-entry that occurred in a patient with history of prior cardiac surgery. By correcting incorrect annotation of double potentials at the cavotricuspid isthmus lesion, the local activation time map showed a re-entrant circuit rotating around a low-voltage area within the cavotricuspid isthmus region. Preoperative computed tomography revealed a pouch on the septal side of the cavotricuspid isthmus that was anatomically adjacent to the boundary of the tachycardia circuit. Termination of tachycardia was achieved by typical cavotricuspid isthmus linear ablation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The formation of a low-voltage area, which might have been created by prior surgery, was presumed to contribute to the maintenance of intra-isthmus re-entry as a kind of boundary. By use of an ultra-high-resolution mapping system and the entrainment pacing manoeuvre, we could clearly delineate the tachycardia circuit and determine an ablation strategy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag491","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:52:50Z","timestamp":1783597970000},"source":"Crossref","is-referenced-by-count":0,"title":["True type of intra-cavotricuspid isthmus re-entrant atrial tachycardia: a case report"],"prefix":"10.1093","volume":"10","author":[{"given":"Daichi","family":"Miyake","sequence":"first","affiliation":[{"name":"Clinical Engineering Center, Wakayama Medical University , 811-1, Kimiidera, Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4775-3531","authenticated-orcid":false,"given":"Manabu","family":"Kashiwagi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Wakayama Medical University , 811-1, Kimiidera, Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7553-024X","authenticated-orcid":false,"given":"Satoshi","family":"Hata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Wakayama Medical University , 811-1, Kimiidera, Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Teruya","sequence":"additional","affiliation":[{"name":"Clinical Engineering Center, Wakayama Medical University , 811-1, Kimiidera, Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Wakayama Medical University , 811-1, Kimiidera, Wakayama City, Wakayama 641-8509 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"2026072315363686100_ytag491-B1","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1111\/j.1540-8159.2005.00186.x","article-title":"Reentry within the cavotricuspid isthmus: an isthmus dependent circuit","volume":"28","author":"Yang","year":"2005","journal-title":"Pacing Clin Electrophysiol"},{"key":"2026072315363686100_ytag491-B2","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.ipej.2023.04.014","article-title":"Delineation of an intra-isthmus reentry circuit around the coronary sinus ostium using an ultrahigh-resolution mapping system","volume":"23","author":"Sekihara","year":"2023","journal-title":"Indian Pacing Electrophysiol J"},{"key":"2026072315363686100_ytag491-B3","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1111\/j.1540-8167.2010.01778.x","article-title":"Prospective observations in the clinical and electrophysiological characteristics of intra-isthums reentry","volume":"21","author":"Yang","year":"2010","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2026072315363686100_ytag491-B4","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1111\/j.1540-8167.1998.tb00091.x","article-title":"The architecture of the atrial musculature between the orifice of the inferior caval vein and the tricuspid valve: the anatomy of the isthmus","volume":"9","author":"Cabrera","year":"1998","journal-title":"J Cardiovasc Electrophysiol"},{"key":"2026072315363686100_ytag491-B5","first-page":"283","article-title":"The arrangement of muscle fibres in the region of the subthebesian fossa in the aspect of atrial flutter","volume":"61","author":"Koz\u0142owski","year":"2002","journal-title":"Folia Morphol (Warsz)"},{"key":"2026072315363686100_ytag491-B6","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1002\/joa3.12251","article-title":"Missing pouches in high-density mapping of atrial tachyarrhythmia in congenital heart diseases","volume":"35","author":"Kwok","year":"2019","journal-title":"J Arrhythm"},{"key":"2026072315363686100_ytag491-B7","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCEP.118.007394","article-title":"Ripple-AT study: a multicenter and randomized study comparing 3D mapping techniques during atrial tachycardia ablations","volume":"12","author":"Luther","year":"2019","journal-title":"Circ Arrhythm Electrophysiol"}],"container-title":["European Heart Journal - 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