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A Case of Cor Triatriatum With an Abnormal P Wave: The Pacemaker Action From the Specialized Tissue in the Abnormal Septum

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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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Acknowledgment

The authors acknowledge Drs. Shigehiro Morishima, M.D. and Takashi Ono, M.D. for the operation and Dr Hideo Sakuma, M.D. for the pathologic analysis. This work was supported by an intra-institutional fund.

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Authors and Affiliations

  1. Department of Pediatrics, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan

    Yoshimichi Kudo & Mariko Kaneko

  2. Pediatric and Lifelong Congenital Cardiology Institute, Southern Tohoku Research Institute for Neuroscience, Southern Tohoku General Hospital, 7-115 Yatsuyamada, Koriyama, Fukushima, 963-8563, Japan

    Makoto Nakazawa

  3. Department of Pediatric Cardiology, Tokyo Women’s Medical University, Tokyo, Japan

    Sachiko Tomita

Authors
  1. Yoshimichi Kudo
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  2. Mariko Kaneko
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  3. Makoto Nakazawa
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  4. Sachiko Tomita
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Corresponding author

Correspondence to Yoshimichi Kudo.

Electronic supplementary material

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Movie clip 1 2DE two-dimensional echocardiogram showing the abnormal membrane. (MOV 516 kb)

Movie clip 2 Color Doppler echocardiogram showing the flow from the accessory chamber to the left atrium (LA). (MOV 512 kb)

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Kudo, Y., Kaneko, M., Nakazawa, M. et al. A Case of Cor Triatriatum With an Abnormal P Wave: The Pacemaker Action From the Specialized Tissue in the Abnormal Septum. Pediatr Cardiol 32, 1244–1248 (2011). https://doi.org/10.1007/s00246-011-0078-6

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  • DOI: https://doi.org/10.1007/s00246-011-0078-6

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