ArticleJACC. Case reports2026
Right-Atrial Muscular Ridge as an Isthmus for Macro-Re-Entrant Atrial Tachycardia in Partial Atrial Standstill.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPartial 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-re-entrant 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-re-entrant AT in an extensively scarred atrium.
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