{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T03:31:09Z","timestamp":1778729469830,"version":"3.51.4"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Although entrainment mapping is an established approach to atypical atrial flutter ablation, postpacing intervals shorter than tachycardia cycle length (difference between postpacing interval and tachycardia cycle length [dPPI] &lt;0 ms) remain of unknown significance. We sought to compare anatomic and electrophysiological properties of sites with dPPI &lt;0, dPPI=0\u201330, and dPPI &gt;30 ms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>We studied 24 noncavotricuspid isthmus\u2013dependent macroreentrant atypical atrial flutter in 19 consecutive patients. Ultra high-density electroanatomic activation maps were acquired with a 64-electrode basket catheter. Entrainment mapping was performed at multiple candidate sites. Ablation was performed at the narrowest accessible slow-conducting critical isthmuses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>\n              Of 102 entrainment mapping sites, dPPI &lt;30 was observed at 72 sites on complete maps of 24 atypical atrial flutter. Compared with dPPI=0\u201330 sites (N=45), dPPI&lt;0 sites (N=27) were more commonly located within isthmuses &lt;15 mm wide (67% versus 6.7%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.00001; odds ratio, 28.0; 95% CI, 6.8\u2013115.7), more frequently located within 5 mm of the leading wavefront (93% versus 64%,\n              <jats:italic>P<\/jats:italic>\n              =0.008), exhibited slower local conduction velocity (0.49\u00b10.43 versus 0.93\u00b10.57 m\/s,\n              <jats:italic>P<\/jats:italic>\n              =0.0005), lower voltages (0.48\u00b10.79 versus 0.92\u00b10.97 mV,\n              <jats:italic>P<\/jats:italic>\n              =0.04), and more frequently fractionated electrograms (67% versus 24%,\n              <jats:italic>P<\/jats:italic>\n              =0.0004). High rates of arrhythmia termination or cycle length increase &gt;15 ms by ablation were observed in both dPPI groups (94% versus 86%,\n              <jats:italic>P<\/jats:italic>\n              =0.53). Compared with all dPPI &lt;30, dPPI &gt;30 sites (N=30) were less commonly observed within isthmuses (3.3%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or within 5 mm of the leading wavefront (30%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001); conduction velocity (1.0\u00b10.7 m\/s,\n              <jats:italic>P<\/jats:italic>\n              =0.002) and voltage (1.1\u00b11.4 mV,\n              <jats:italic>P<\/jats:italic>\n              =0.049) were higher compared with dPPI&lt;0 but similar to dPPI=0\u201330 sites.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>In atypical atrial flutter, sites with dPPI &lt;0 are markers of limited width critical isthmuses with slower conduction velocity, whereas sites with dPPI=0\u201330 ms are often not in close proximity to the reentry circuit. Virtual electrode simultaneous down and upstream (antidromic) capture of a confined isthmus of slow conduction can explain a dPPI &lt;0. Identifying these sites may improve selective and efficient ablation strategies compared with the standard 30-ms threshold.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.118.006955","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T09:00:24Z","timestamp":1552554024000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Electrophysiological and Anatomical Correlates of Sites With Postpacing Intervals Shorter Than Tachycardia Cycle Length in Atypical Atrial Flutter"],"prefix":"10.1161","volume":"12","author":[{"given":"Nicolas","family":"Johner","sequence":"first","affiliation":[{"name":"Cardiology Division, University Hospitals of Geneva (N.J., D.C.S., P.B.D., M.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dipen C.","family":"Shah","sequence":"additional","affiliation":[{"name":"Cardiology Division, University Hospitals of Geneva (N.J., D.C.S., P.B.D., M.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florian","family":"Jousset","sequence":"additional","affiliation":[{"name":"Boston Scientific, Rhythm Management, Solothurn, Switzerland (F.J.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro Bernardo","family":"Dall\u2019Aglio","sequence":"additional","affiliation":[{"name":"Cardiology Division, University Hospitals of Geneva (N.J., D.C.S., P.B.D., M.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Namdar","sequence":"additional","affiliation":[{"name":"Cardiology Division, University Hospitals of Geneva (N.J., D.C.S., P.B.D., M.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2001.2658"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.25.2928"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00563-1"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.004560"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.111.968602"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12852"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2006.00413.x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.103.16.2060"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1999.tb00640.x"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1997.tb00805.x"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.88.4.1647"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.118.006955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:02:32Z","timestamp":1715558552000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.118.006955"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1161\/CIRCEP.118.006955"],"URL":"https:\/\/doi.org\/10.1161\/circep.118.006955","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]},"assertion":[{"value":"2018-10-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-03-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006955"}}