Figure 5:
A: Widespread distribution of the earliest atrial activation sites (EAS) recorded with epicardial bipolar electrodes in patients. The EAS formed a widely distributed region along the CT which greatly exceeded dimensions of the human SAN. B. Ex-vivo CE-CMR with human 3D SAN model showing common EAS/Exit sites from SAN via superior, middle and inferior SACPs defined by NIOM in ex-vivo human studies18,5,12,2,3. C. Distribution of successful ablation sites of atrial tachycardias on the CT. 3D SAN model showing surface exit sites via the superior and inferior SACPs near the SAN head and tail, respectively. E. Simultaneous endocardial-epicardial mapping of the SAN /CT showing post-pacing caudal shift in activation exits with marked asymmetry in endo–epi exit sites. (Modified from16,38,44).