Key result
Inferior SAN exit sites show ~50% lower voltages and prolonged RA activation versus superior sites.
Why the study?
Are inferior sino-atrial node exit sites associated with electrical remodeling in patients with structural heart disease?
Observational (n=27)
No
Are inferior sino-atrial node exit sites associated with electrical remodeling in patients with structural heart disease?
Absolute Event Rate: 1.3% vs 2.6%
p-value: p=0.014
Inferior sino-atrial node exit sites identified by high-resolution epicardial mapping are associated with extensive right atrial remodeling.
May identify right atrial remodeling; hypothesis-generating, no practice change warranted.
BACKGROUND: region remain poorly understood. OBJECTIVES: . METHODS: High-resolution epicardial mapping was performed in 27 patients with structural heart disease undergoing elective open-heart surgery. Electrodes within an 8-mm radius of the SAN exit site were classified as the SAN area. Electrophysiological properties, including potential voltage, conduction block, and R/S ratios, were computed. RESULTS: patients (median: 89 [Q1-Q3: 79-98] vs 78 [Q1-Q3: 66-85] milliseconds; P = 0.046). Heart rates were comparable between groups and remained consistent during both the preoperative and intraoperative periods. CONCLUSIONS: identified by high-resolution epicardial mapping were associated with extensive RA remodeling and are most likely due to altered sino-atrial conduction pathways.
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Zheng et al. (2025) conducted an observational in Structural heart disease (n=27). Inferior sino-atrial node exit sites vs. Superior sino-atrial node exit sites was evaluated on Potential voltages at SAN exit sites (p=0.014). Inferior sino-atrial node exit sites were associated with lower potential voltages (1.3 vs 2.6 mV, p=0.014) and prolonged right atrial activation times compared to superior exit sites.
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