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Related Experiment Video

Updated: Jun 8, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation

Published on: July 20, 2022

An alternative method of assessing bidirectional block for atrial flutter.

Matthew T Bennett¹, Lorne J Gula, George J Klein

¹Division of Cardiology, University of Western Ontario, London, Ontario, Canada.

Journal of Cardiovascular Electrophysiology

|October 16, 2010

Summary

This study shows that right ventricular pacing can effectively assess bidirectional block in cavotricuspid isthmus ablation without coronary sinus pacing. This simplified method accurately confirms block, aiding successful procedures.

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Area of Science:

Cardiology
Electrophysiology
Cardiac Ablation

Background:

Cavotricuspid isthmus (CTI) ablation success relies on bidirectional block.
Right ventricular (RV) pacing can substitute for coronary sinus (CS) pacing in assessing CTI conduction block.

Purpose of the Study:

To evaluate bidirectional conduction using antegrade (A-V) and retrograde (V-A) conduction times without CS pacing.
To establish an abbreviated technique for assessing CTI block.

Main Methods:

Assessed counterclockwise CTI block using conduction times from lateral pacing sites to QRS.
Compared these times to those measured with CS pacing.
Evaluated clockwise CTI block using conduction times during RV and CS pacing.

Main Results:

The abbreviated technique accurately identified bidirectional block in all patients.
Conduction times correlated well between the two methods before and after ablation.
High correlation coefficients (r=0.82-0.92) confirmed method validity.

Conclusions:

Bidirectional CTI block can be confirmed without CS pacing using A-V and V-A conduction.
The method requires intact A-V and V-A AV nodal conduction.
This simplifies CTI block assessment during ablation.