Topology and conduction in the inferior right atrial isthmus measured in rabbit hearts.

The inferior right atrial isthmus consisting of the terminal crest, the network of pectinate muscles, and the vestibule shows very complex anatomical structure. It is seen as potential substrate for atrial flutter. In this work we present results from an electro-anatomical characterization of this region based on Cardiac Near Field recordings taken from five preparations of rabbit atrium. Pectinate muscles in the region of interest were divided into three segments: central as well as proximal and distal with respect to the terminal crest. Electrograms measured in these segments showed differences in the degree of fractionation, i.e. the numbers of distinct local activation events, indicating heterogeneities in microstructure. From 249 recording sites 63.9% showed no fractionation, 26.9% showed two activation events, and 9.2% were highly fractionated. The proximal starting sequence of activation in a series of adjacent pectinate muscles is not sorted but rather seems to be arbitrary. The same applies to the arrival sequence of activation close to the vestibule. In the network of pectinate muscles on average one proximal segment branches into two central strands and two central strands merge into one distal stem.