The Bachmann bundle and interatrial conduction: comparing atrial morphology to electrical activity.
Activation patterns
Bachmann bundle
Epicardial mapping
Interatrial conduction
Morphology
Journal
Heart rhythm
ISSN: 1556-3871
Titre abrégé: Heart Rhythm
Pays: United States
ID NLM: 101200317
Informations de publication
Date de publication:
04 2019
04 2019
Historique:
received:
09
06
2018
pubmed:
27
10
2018
medline:
6
10
2020
entrez:
27
10
2018
Statut:
ppublish
Résumé
The Bachmann bundle (BB) is one of the major interatrial muscular connections. Macroscopic anatomy and electrophysiological properties of BB have so far not been linked, and differences in activation patterns are most likely due to anatomical variations. The goals of this study were to analyze different activation patterns and couple those wavefronts to epicardial morphological structures on cadaveric hearts. High-resolution epicardial mapping over BB during sinus rhythm was performed in 185 patients undergoing coronary artery bypass graft surgery. The epicardial atrial musculature was macroscopically examined in 19 postmortem dissected human hearts, which are different from those examined in the mapping study. The morphology of BB and surrounding interatrial connections were evaluated. Activation patterns were subsequently linked to morphological variance found in the dissected hearts. Epicardial mapping showed that BB is activated in a right-to-left direction in the majority of patients. In almost one-third of patients, a wavefront emerging or entering in the middle of BB was also observed. In some patients, left-to-right activation of BB was observed. BB was macroscopically present in all postmortem hearts. In addition, a newly found posterosuperior bundle was consistently seen, joining BB from the posterior border over the interatrial groove. Other connections identified were the septopulmonary bundle and posterior interatrial connections. The morphological interatrial connections correspond to the interatrial pathways observed with high-resolution epicardial mapping of BB. Of these connections, BB and the posterosuperior bundle seem to be most consistent, both morphologically and electrophysiologically.
Sections du résumé
BACKGROUND
The Bachmann bundle (BB) is one of the major interatrial muscular connections. Macroscopic anatomy and electrophysiological properties of BB have so far not been linked, and differences in activation patterns are most likely due to anatomical variations.
OBJECTIVES
The goals of this study were to analyze different activation patterns and couple those wavefronts to epicardial morphological structures on cadaveric hearts.
METHODS
High-resolution epicardial mapping over BB during sinus rhythm was performed in 185 patients undergoing coronary artery bypass graft surgery. The epicardial atrial musculature was macroscopically examined in 19 postmortem dissected human hearts, which are different from those examined in the mapping study. The morphology of BB and surrounding interatrial connections were evaluated. Activation patterns were subsequently linked to morphological variance found in the dissected hearts.
RESULTS
Epicardial mapping showed that BB is activated in a right-to-left direction in the majority of patients. In almost one-third of patients, a wavefront emerging or entering in the middle of BB was also observed. In some patients, left-to-right activation of BB was observed. BB was macroscopically present in all postmortem hearts. In addition, a newly found posterosuperior bundle was consistently seen, joining BB from the posterior border over the interatrial groove. Other connections identified were the septopulmonary bundle and posterior interatrial connections.
CONCLUSION
The morphological interatrial connections correspond to the interatrial pathways observed with high-resolution epicardial mapping of BB. Of these connections, BB and the posterosuperior bundle seem to be most consistent, both morphologically and electrophysiologically.
Identifiants
pubmed: 30366158
pii: S1547-5271(18)31048-8
doi: 10.1016/j.hrthm.2018.10.021
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
606-614Informations de copyright
Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.