{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:49:51Z","timestamp":1790934591380,"version":"4.1.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1995,10]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            The importance of barriers in atrial flutter has been demonstrated in animals. We used activation and entrainment mapping, guided by intracardiac echocardiography (ICE), to determine whether the crista terminalis (CT) and eustachian ridge (ER) are barriers to conduction during typical atrial flutter in humans.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            In eight patients, ICE was used to guide the placement of 20-pole and octapolar catheters along the CT and interatrial septum and a roving catheter to nine sites: just posterior (1) and anterior (2) to the CT along the lateral right atrium, at the fossa ovalis (3), and just posterior and anterior to the ER at the low posterolateral (4 and 5), low posterior (6 and 7), and low posteromedial (8 and 9) right atrium. Entrainment was performed, and each site was considered within the flutter circuit if the postpacing interval\u2013flutter cycle length (PPI\u2212FCL) and the stimulus time\u2013activation time (stim time\u2212act time) were &lt;10 msec. Split potentials were recorded along the CT with components activated in a low-to-high pattern and a high-to-low pattern. Conduction times, as percentage of FCL, were significantly different at sites on either side of the CT and ER: site 1 (33\u00b113%) and site 2 (43\u00b112%) (\n            <jats:italic>P<\/jats:italic>\n            =.02), site 4 (48\u00b124%) and site 5 (75\u00b18.9%) (\n            <jats:italic>P<\/jats:italic>\n            =.02), and site 6 (22\u00b110%) and site 7 (82\u00b15.3%) (\n            <jats:italic>P<\/jats:italic>\n            =.0009). During entrainment, no surface fusion was observed at sites 5, 7, or 9. The PPI\u2212FCL and stim time\u2212act time were not significantly different than 0 at sites 2, 7, 5, or 9, indicating that they were within the flutter circuit, whereas sites 1, 3, 4, and 6 were not.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            ICE enabled the correlation of functional electrophysiological properties with specific anatomic landmarks, identifying the CT and ER as barriers to conduction during human atrial flutter.\n          <\/jats:p>","DOI":"10.1161\/01.cir.92.7.1839","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:34:42Z","timestamp":1339461282000},"page":"1839-1848","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":392,"title":["Role of Right Atrial Endocardial Structures as Barriers to Conduction During Human Type I Atrial Flutter"],"prefix":"10.1161","volume":"92","author":[{"given":"Jeffrey E.","family":"Olgin","sequence":"first","affiliation":[{"name":"From the Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Kalman","sequence":"additional","affiliation":[{"name":"From the Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam P.","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"From the Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D.","family":"Lesh","sequence":"additional","affiliation":[{"name":"From the Section of Cardiac Electrophysiology, Department of Medicine and Cardiovascular Research Institute, University of California San Francisco."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(47)90084-7"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.76.5.3665000"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.79.2.2914353"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(93)90817-K"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(92)90115-4"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960150910"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.1992.tb04174.x"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.81.3.2306821"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.86.4.1394929"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(90)90314-F"},{"key":"e_1_3_2_11_2","first-page":"795","volume":"64","year":"1989","unstructured":"Touboul P, Saoudi N, Atallah G, Kirkorian G. 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