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Figure 6 Right atrial (RA) loop position: preablation and postablation recordings, gross lesions and fluoroscopic image. Electrode 1 is located at the inferior vena cava (IVC) atrial junction (note the low amplitude recording at electrode pair 1–2). The recordings from electrodes 1 to 9 are from the IVC–superior vena cava (SVC) region of the atrium. Electrode pair 9–10 traverses the SVC as depicted by the low electrogram amplitude. Electrodes 10 to 12 display the earliest electrograms, from the sinus node region at the anterior junction of the SVC and right atrial appendage (RAA). The recordings 13 to 22 are from across the RAA, and the remaining recordings traverse the tricuspid ring into the right ventricle. In regions progressively closer to the atrioventricular junction, the amplitude of the ventricular wave increases. Postablation, the propagation of the right atrial depolarization sequence still initiates from the region recorded by electrodes 9 to 11. However, the creation of the lesion resulted in a marked decrease in the electrograms’ amplitude and fragmentation of the local recordings. These double potentials coincide with the creation of contiguous linear lesions. TV = tricuspid valve.
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