High‐Resolution Mapping of Tachycardia Originating from the Superior Vena Cava: Evidence of Electrical Heterogeneity, Slow Conduction, and Possible Circus Movement Reentry
High‐Resolution Mapping of Tachycardia Originating from the Superior Vena Cava: Evidence of Electrical Heterogeneity, Slow Conduction, and Possible Circus Movement Reentry
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DOI：
10.1046/j.1540-8167.2002.00388.x
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发表时间：
2002-04
影响因子：
2.7
通讯作者：
D. Shah;Michel Häissaguerre;Pierre Jäis;J. Clémenty
中科院分区：
文献类型：
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作者：
D. Shah;Michel Häissaguerre;Pierre Jäis;J. Clémenty
上级腔静脉折返。描述了房颤患者起源于上级腔静脉（SVC）的心动过速的高分辨率标测。在SVC心肌袖内阻滞线周围记录了包含完整心动过速周期长度的单向迂回重复激动。间歇性传导至右心房导致不规则房性心动过速。电异质性和缓慢传导的证据在窦性心律中持续存在，并被过早刺激夸大，但在心动过速期间没有再现激活模式。所有可用的证据都与上腔静脉内的马戏团运动折返最一致，折返回路的尺寸有限，传导明显缓慢且各向异性。这些发现可能提示肺静脉心肌中存在类似的底物和心律失常机制。
Superior Vena Cava Reentry. High‐resolution mapping of a tachycardia originating from the superior vena cava (SVC) in a patient with atrial fibrillation is described. Unidirectional circuitous repetitive activation encompassing the full tachycardia cycle length was documented around a line of block within the myocardial sleeve of the SVC. Intermittent conduction to the right atrium resulted in an irregular atrial tachycardia. Evidence of electrical heterogeneity and slow conduction persisted in sinus rhythm and was exaggerated by premature stimulation but did not reproduce the activation pattern during tachycardia. All the available evidence is best compatible with circus movement reentry within the SVC, with marked slow and anisotropic conduction responsible for the restricted dimensions of the reentrant circuit. These findings may suggest a similar substrate and arrhythmia mechanism in the myocardium of the pulmonary veins.