当前位置： SCI文献检索 > JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY期刊下所有文献 > Ablation of posteroseptal and left posterior accessory pathways guided by left atrium-coronary sinus musculature activation sequence.

Ablation of posteroseptal and left posterior accessory pathways guided by left atrium-coronary sinus musculature activation sequence.

Abstract：

INTRODUCTION:While some posteroseptal and left posterior accessory pathways (APs) can be ablated on the tricuspid annulus or within the coronary venous system, others require a left-sided approach. "Fragmented" or double potentials are frequently recorded in the coronary sinus (CS), with a smaller, blunt component from left atrial (LA) myocardium, and a larger, sharp signal from the CS musculature. METHODS AND RESULTS:Forty patients with posteroseptal or left posterior AP were included. The LA-CS activation sequence was determined at the earliest site during retrograde AP conduction. Eleven APs (27.5%) were ablated on the tricuspid annulus (right endocardial), 9 (22.5%) inside the coronary venous system (epicardial), and 20 (50%) on the mitral annulus (left endocardial). A "fragmented" or double "atrial" potential was recorded in all patients inside the CS at the earliest site during retrograde AP conduction. Sharp potential from the CS preceded the LA blunt component (sharp/blunt sequence) in all patients with an epicardial AP, and in 10 of 11 (91%) patients with a right endocardial AP. Therefore, 18 of 19 (95%) APs ablated by a right-sided approach produced this pattern. The reverse sequence (blunt/sharp) was recorded in 19 of 20 (95%) patients with a left endocardial AP. CONCLUSION:During retrograde AP conduction, the sequence of LA-CS musculature activation-as deduced from analysis of electrograms recorded at the earliest site inside the CS-can differentiate posteroseptal and left posterior APs that require left heart catheterization from those that can be eliminated by a totally venous approach.

journal_name

J Cardiovasc Electrophysiol

journal_title

Journal of cardiovascular electrophysiology

authors

Pap R,Traykov VB,Makai A,Bencsik G,Forster T,Sághy L

doi

10.1111/j.1540-8167.2008.01103.x

subject

Has Abstract

pub_date

2008-07-01 00:00:00

pages

653-8

issue

7

eissn

1045-3873

issn

1540-8167

pii

JCE1103

journal_volume

19

pub_type

临床试验,杂志文章

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