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Flow in and out of the appendage during sinus rhythm.
Flow in and out of the appendage during sinus rhythm. A complex quadriphasic pattern can be appreciated. Two inflow (below line) and two outflow (above line) phases are present. During atrial systole (after the P wave) a clear period of flow out of the appendage is seen. This is followed by flow into the appendage during ventricular systole (QRS complex). Two further waves are seen: an outflow wave (ventricular relaxation), and an inflow wave (probably related to appendageal elasticity). N M Al-Saady et al. Heart 1999;82: Copyright © BMJ Publishing Group Ltd & British Cardiovascular Society. All rights reserved.
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