Why the study?
Bi-atrial reentrant circuits pose major clinical challenges because the involvement of both atria and epicardial conductions complicates endocardial mapping.
Understanding the anatomy of interatrial connections and epicardial fibers is essential for interpreting electrophysiological findings and guiding ablation strategies in bi-atrial tachycardias.
May guide bi-atrial tachycardia ablation via interatrial anatomy; leaves open prospective validation of strategies.
Bi-atrial tachycardia (BiAT) is not rare after extensive atrial ablation or cardiac surgery. The complexity of bi-atrial reentrant circuits poses a great challenge for clinical practice. With recent advances in mapping technologies, we are now able to characterize atrial activation in detail. However, given the involvement of both atria and multiple epicardial conductions, endocardial mapping for BiATs is not easy to understand. Knowledge of the atrial myocardial architecture is the foundation for the clinical management of BiATs; as it is required to understand the possible mechanism of the tachycardia and identify the optimal target of ablation. In this review we summarize current knowledge about the anatomy of interatrial connections as well as other epicardial fibers and discuss the interpretation of electrophysiological findings and ablation strategies for BiATs.
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Lai et al. (2023) studied this question.
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