キンジヨウ　タカヒコ   KINJIYOU Takahiko   金城　貴彦    所属   医学部 医学科（東京女子医科大学病院）    職種   助教
論文種別	症例報告
言語種別	英語
査読の有無	査読あり
表題	Right-Atrial Muscular Ridge as an Isthmus for Macro-Reentrant Atrial Tachycardia in Partial Atrial Standstill.
掲載誌名	正式名：JACC. Case reports 略　 称：JACC Case Rep ISSNコード：26660849/26660849
掲載区分	国外
巻・号・頁	pp.109429
著者・共著者	Ken Yamazaki†, Takahiko Kinjo*, Masaomi Kimura, Yuji Ishida, Hirofumi Tomita
発行年月	2026/07
概要	BACKGROUND:Partial atrial standstill is a rare disorder with extensive atrial electrical silence that can coexist with atrial tachycardia (AT). However, the mechanism of AT in this population remains unclear.CASE SUMMARY:A 54-year-old man was referred for AT and complete atrioventricular block. High-resolution electroanatomic mapping revealed extensive electrically silent areas involving the sinus venarum and right atrial septum, consistent with partial atrial standstill. In contrast, a preserved right atrial muscular ridge (arcuate ridge and crista terminalis) formed the critical isthmus of a macro-reentrant circuit. Ablation of this ridge, followed by cavotricuspid isthmus ablation, terminated the AT. A permanent pacemaker was subsequently implanted. The patient remained free of atrial tachyarrhythmia for 7 years.DISCUSSION:Preserved muscular ridges can be key conduction pathways and ablation targets in an extensively scarred atrium.TAKE-HOME MESSAGES:Muscular ridges can serve as a conduction pathway of macro-reentrant AT in an extensively scarred atrium.
DOI	10.1016/j.jaccas.2026.109429
PMID	42496628