Abstract:
INTRODUCTION:Mapping procedures to identify triggers of atrial fibrillation from pulmonary veins (PVs) are not well established. We sought to determine the value of multipolar recordings from the coronary sinus (CS) and crista terminalis (CT) for identifying the origin of paced and atrial premature depolarizations (APDs) initiating atrial fibrillation from left versus right PVs. METHODS AND RESULTS:Fifteen patients with paroxysmal atrial fibrillation refractory to medications had decapolar catheters (5-mm electrode, 2-mm interelectrode spacing) placed in the CS and posterior medial to the CT. Bipolar electrograms were recorded at each site. Electroanatomic left atrial endocardial maps were created in sinus rhythm, and each PV was identified and paced. During spontaneous APDs initiating atrial fibrillation and PV pace maps, the atrial activation and the earliest electrogram at CS and CT were compared. PV sites were designated as sites of origin of APDs when (1) intracardiac electrograms in the CS and CT during arrhythmogenic APDs matched those of PV pace maps, (2) local activation preceded CS and CT recordings by at least 40 msec (all sites), and (3) atrial depolarizations were eliminated by application of radiofrequency energy (24/26 sites). Pacing from each of the 30 right PV sites resulted in proximal to distal CS activation and later recordings at the CS than the CT (earliest CS-CT activation range: -15 to -58 msec, mean -32 +/- 12). In contrast, pacing from the left PV sites typically (28/30 sites) activated the CS from the distal to proximal poles and demonstrated simultaneous or earlier (CS-CT range: -14 to +54 msec, mean 13 +/- 17) recordings of the CS than the CT (P < 0.0001). For 13 APDs mapped to the right PVs, CS minus CT activation was -17 to -49 msec (mean -31 +/- 8). For 13 APDs localized to the left PVs, the CS minus CT activation time ranged from -8 to +28 msec (mean 14 +/- 15). CONCLUSION:Activation sequence mapping from multipolar catheters placed in the CS and along the posterior medial CT rapidly differentiates right and left PV sites of origin of atrial depolarization.
journal_name
J Cardiovasc Electrophysioljournal_title
Journal of cardiovascular electrophysiologyauthors
Ashar MS,Pennington J,Callans DJ,Marchlinski FEdoi
10.1046/j.1540-8167.2000.01300.xkeywords:
subject
Has Abstractpub_date
2000-12-01 00:00:00pages
1300-5issue
12eissn
1045-3873issn
1540-8167journal_volume
11pub_type
临床试验,杂志文章abstract:INTRODUCTION:Although balloon-based techniques, such as the laser balloon (LB) ablation have simplified pulmonary vein isolation (PVI), procedural fluoroscopy usage remains higher in comparison to radiofrequency PVI approaches due to limited 3-dimensional mapping system integration. METHODS:In this prospective study, ...
journal_title:Journal of cardiovascular electrophysiology
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pub_type: 杂志文章,随机对照试验
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journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.2011.02164.x
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abstract:INTRODUCTION:Echocardiography is widely used to optimize CRT programming, but it is time-consuming. This study aimed to correlate the optimal interventricular pacing (V-V) interval obtained by echo with the optimal V-V interval obtained by a simpler method based on the surface ECG. METHODS AND RESULTS:Three V-V interv...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1111/j.1540-8167.2007.00983.x
更新日期:2007-12-01 00:00:00
abstract:INTRODUCTION:Despite technical progress, ventricular tachycardia (VT) recurrence after unipolar ablation remains relatively high (12%-47%). Bipolar ablation has been proposed as an appealing solution that may overcome limitations associated with unipolar ablation settings. We designed an animal study to compare bipolar...
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更新日期:2019-10-01 00:00:00
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更新日期:1995-10-01 00:00:00
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abstract:INTRODUCTION:Electrophysiological mapping (EPM) in coronary sinus (CS) branches is feasible for guiding LV lead placement to the optimal, latest activated site at cardiac resynchronization therapy (CRT) procedures. However, whether this procedure optimizes the response to CRT has not been demonstrated. This study was t...
journal_title:Journal of cardiovascular electrophysiology
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更新日期:2006-01-01 00:00:00
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更新日期:2020-12-18 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Atrial arrhythmias have emerged as a topic of great interest for clinical electrophysiologists. Noninvasive imaging of electrical function in humans may be useful for computer-aided diagnosis and treatment of cardiac arrhythmias, which can be accomplished by the fusion of data from ECG mapping and magnetic...
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pub_type: 临床试验,杂志文章
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更新日期:2003-07-01 00:00:00
abstract::Macro-Reentrant ARVC epi-VT with a Focal Endo-Activation. A 55-year-old man with arrhythmogenic right ventricular cardiomyopathy underwent catheter ablation of ventricular tachycardia (VT) with left bundle branch block and left superior axis QRS morphology with an early precordial transition. Endocardial mapping durin...
journal_title:Journal of cardiovascular electrophysiology
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doi:10.1111/j.1540-8167.2008.01395.x
更新日期:2009-06-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2001.00349.x
更新日期:2001-03-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1540-8167.2001.00145.x
更新日期:2001-02-01 00:00:00
abstract:INTRODUCTION:Radiofrequency ablation (RFCA) of ventricular tachycardia (VT) is a potential curative treatment modality. We evaluated the results of RFCA in patients with VT. METHODS AND RESULTS:One hundred fifty-one consecutive patients (122 men and 29 women; age 57 +/- 16 years) with drug-refractory VT were treated. ...
journal_title:Journal of cardiovascular electrophysiology
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更新日期:2002-05-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2010-09-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2002.01164.x
更新日期:2002-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章,meta分析,评审
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更新日期:2017-12-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2000.tb00029.x
更新日期:2000-06-01 00:00:00
abstract:UNLABELLED:VT Ablation in Apical Hypertrophic Cardiomyopathy. INTRODUCTION:Monomorphic ventricular tachycardia (VT) is uncommon in apical hypertrophic cardiomyopathy (HCM). The purpose of this study was to define the substrate and role of catheter ablation for VT in apical HCM. METHODS:Four patients with apical HCM ...
journal_title:Journal of cardiovascular electrophysiology
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更新日期:2011-01-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/jce.14377
更新日期:2020-04-01 00:00:00
abstract::Several techniques are used for AF ablation, but no general consensus exists as to which technique is the most effective. At our center, we have developed a technique for isolating the pulmonary veins (PVs) at their antrum. The technique is guided by intracardiac echocardiography (ICE) and mapping with a circular (Las...
journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1046/j.1540-8167.2004.04428.x
更新日期:2004-11-01 00:00:00
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journal_title:Journal of cardiovascular electrophysiology
pub_type: 杂志文章
doi:10.1111/j.1540-8167.2007.00773.x
更新日期:2007-05-01 00:00:00