Applied Cardiac Anatomy for Electrophysiologists Dr Mohamed Azzam

Learning Objectives

By the end of this workshop, participants will be able to:
1. Identify key anatomical landmarks relevant to cardiac conduction.
2. Understand 3D relationships between atrial and ventricular structures.
3. Correlate imaging modalities (CT/MRI, ICE) with anatomical features.
4. Apply anatomical knowledge to EP procedures (e.g., AF ablation, VT ablation, device
implantation).
5. Recognize anatomical variants and pitfalls during mapping and ablation.

Workshop Structure

Day 1: Core Anatomy & Imaging Session 1: Orientation & Overview
• Welcome & Introduction to EP-oriented Anatomy
• Interactive quiz (pre-test)
Session 2: Right Atrium & AV Node Region
• Sinus node anatomy
• Crista terminalis, eustachian ridge, cavotricuspid isthmus
• AV node and triangle of Koch
• Relevant arrhythmias: AVNRT, typical flutter
• Correlation with EP maneuvers
Session 3: Left Atrium & Pulmonary Veins
• Left atrial appendage
• Pulmonary vein anatomy and variability
• Fibrous skeleton & mitral isthmus
• Roof and posterior wall anatomy
• AF ablation targets and complications
Session 4: Imaging Correlation

• Intracardiac echo (ICE)
• CT/MRI overlays for mapping
• 3D reconstructions and segmentation tools
Session 5: Ventricular Anatomy for VT Ablation
• RV vs LV anatomy
• Septal and free wall anatomy
• Outflow tracts (RVOT, LVOT)
• Papillary muscles, false tendons, Purkinje network
• Epicardial anatomy: fat, coronaries, phrenic nerve
Session 6: Access & Navigation
• Transseptal puncture anatomy
• Coronary sinus and vein of Marshall
• Navigating complex anatomy using electroanatomic mapping
Session 7: Hands-On & Simulation
• 3D printed hearts or virtual dissection tools
• Live or recorded cadaver lab dissection
• Simulators: CARTO/EnSite with imaging overlays
• ICE navigation practice
Session 8: Clinical Case Integration
• Real-life ablation case walkthroughs
• Anatomy-related challenges and complications
• Q&A panel with expert faculty
Wrap-up
• Post-test & feedback
• Key takeaways and anatomical “checklist” for EP