Atrial fibrillation arising from a silent superior vena cava.
Atrial fibrillation arising from a silent superior vena cava.
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DOI：
10.1016/j.hrcr.2022.12.002
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发表时间：
2023-03
影响因子：
--
通讯作者：
Yamaguchi, Osamu
中科院分区：
文献类型：
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作者：
Fujisawa, Tomoki;Nagai, Takayuki;Kawakami, Hiroshi;Yamaguchi, Osamu
心房颤动（AF）可能起源于肺静脉（PV），在全球范围内，肺静脉隔离已被确定为AF的首选治疗方法。1然而，约20%的AF病例由非肺静脉起源触发，2，3包括上级腔静脉（SVC）。然而，非PV触发的诱发是不可预测的，并且AF触发难以识别。三磷酸腺苷（ATP）可以在消融后发现SVC与右心房（RA）之间以及PV与左心房（LA）之间的休眠传导。4此外，ATP已被用于诱导PV和非PV AF触发。5值得注意的是，通过ATP注射诱导AF和准确识别触发因素在临床上是有用的。我们观察了ATP的影响，包括休眠SVC-RA传导和未消融SVC的放电。
Atrial fibrillations (AF) can originate from the pulmonary veins (PVs), and globally, PV isolation has been established as a treatment method of choice for AF. 1 However, approximately 20% of AF cases are triggered by non-PV origins, 2, 3 including those in the superior vena cava (SVC). However, the inducibility of non-PV triggers is unpredictable, and AF triggers are difficult to identify. Adenosine triphosphate (ATP) can unmask dormant conduction between the SVC and the right atrium (RA) after ablation and between the PVs and the left atrium (LA). 4 Furthermore, ATP has been used to induce PV and non-PV AF triggers. 5 Notably, the induction of AF by ATP injection and accurate identification of triggers is clinically useful. We observed the effects of ATP, including dormant SVC-RA conduction and firing from the nonablated SVC.