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Updated: May 30, 2026

Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
A case of cor triatriatum with an abnormal P wave: the pacemaker action from the specialized tissue in the abnormal
Yoshimichi Kudo1, Mariko Kaneko, Makoto Nakazawa
1Department of Pediatrics, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan. yoshimichi.kudo@mt.strins.or.jp
Abstract:
A boy presented with an abnormal P wave shown on an electrocardiogram (ECG) checkup at school. An echocardiogram and contrast-enhanced computed tomography (CT) showed cor triatriatum with a slit-like opening between the accessory chamber and the left atrium located along the interatrial septum. The boy underwent open heart surgery for excision of the anomalous membrane, and a postoperative ECG showed normal P waves. The excised tissue was examined immnunohistopathologically using antihyperpolarization-activated cyclic nucleotide-gated potassium channel 4 (HCN4) antibody and other staining. The authors confirmed the existence of cells positive to HCN4, indicating that they were sinoatrial node cells or at least cells with electrical automaticity.
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