{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:18:33Z","timestamp":1778224713895,"version":"3.51.4"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1999,6]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014The crista terminalis (CT) has been identified as the posterior boundary of typical atrial flutter (AFL) in the lateral wall (LW) of the right atrium (RA). To study conduction properties across the CT, rapid pacing was performed at both sides of the CT after bidirectional conduction block was achieved in the cavotricuspid isthmus by radiofrequency catheter ablation.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014In 22 patients (aged 61\u00b17 years) with AFL (cycle length, 234\u00b123 ms), CT was identified during AFL by double electrograms recorded between the LW and posterior wall (PW). After the ablation procedure, decremental pacing trains were delivered from 600 ms to 2-to-1 local capture at the LW and PW or coronary sinus ostium (CSO). At least 5 bipolar electrograms were recorded along the CT from the high to the low atrium next to the inferior vena cava. No double electrograms were recorded during sinus rhythm in that area. Complete transversal conduction block all along the CT (detected by the appearance of double electrograms at all recording sites and craniocaudal activation sequence on the side opposite to the pacing site) was observed in all patients during pacing from the PW or CSO (cycle length, 334\u00b1136 ms), but it was fixed in only 4 patients. During pacing from the LW, complete block appeared at a shorter pacing cycle length (281\u00b1125 ms;\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01) and was fixed in 2 patients. In 3 patients, complete block was not achieved.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014These data suggest the presence of rate-dependent transversal conduction block at the crista terminalis in patients with typical AFL. Block is usually observed at longer pacing cycle lengths with PW pacing than with LW pacing. This difference may be a critical determinant of the counterclockwise rotation of typical AFL.\n          <\/jats:p>","DOI":"10.1161\/01.cir.99.21.2771","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:42:29Z","timestamp":1339461749000},"page":"2771-2778","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":99,"title":["Rate-Dependent Conduction Block of the Crista Terminalis in Patients With Typical Atrial Flutter"],"prefix":"10.1161","volume":"99","author":[{"given":"Angel","family":"Arenal","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesus","family":"Almendral","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jesus M.","family":"Alday","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Villacasti\u0301n","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose M.","family":"Ormaetxe","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose Luis M.","family":"Sande","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicasio","family":"Perez-Castellano","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergio","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes","family":"Ortiz","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Luis","family":"Delca\u0301n","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, Hospital General Universitario Gregorio Maran\u0303o\u0301n (A.A., J.A., J.V., J.L.M.S., N.P.-C., S.G., M.O., J.L.D.), Madrid, Spain, and Hospital de Basurto (J.M.A., J.M.O.), Bilbao, Spain."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_1_1_2","first-page":"191","volume":"7","year":"1920","unstructured":"Lewis T, Feil HS, Stroud WD. 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