Mapping and Ablation of Epicardial Idiopathic Ventricular Arrhythmias From Within the Coronary Venous System
Mapping and Ablation of Epicardial Idiopathic Ventricular Arrhythmias From Within the Coronary Venous System
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DOI：
10.1161/circep.109.910802
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发表时间：
2010-06-01
影响因子：
8.4
通讯作者：
Bogun, Frank
中科院分区：
文献类型：
--
作者：
Baman, Timir S.;Ilg, Karl J.;Bogun, Frank
背景--可以通过冠状静脉系统(CVS)消融的心外膜特发性室性心律失常的发生率尚未被描述。方法和结果：在189例特发性室性心律失常患者中，通过激活图和起搏标测确定室性心动过速和/或室性早搏的起始点(SOO)。如果心内膜标测未显示SOO，则在CVS内进行标测。在消融前对CVS进行静脉造影和冠状动脉造影术。在189例患者中，有27例(14%+/-5%；95%可信区间)的室性心律失常是从冠状静脉系统内发现的，包括26例心脏大静脉和1例心脏中静脉。SOO的平均激活时间为-29+/-8ms。27例患者中有20例(74%)在CVS内成功消融。心外膜室性心律失常的V-1波宽于对照组(85ms[四分位数区间，40]对65ms[四分位数区间，95]；P
Background-The prevalence of epicardial idiopathic ventricular arrhythmias that can be ablated from within the coronary venous system (CVS) has not been described.Methods and Results-In a consecutive group of 189 patients with idiopathic ventricular arrhythmias referred for ablation, the site of origin (SOO) of ventricular tachycardia and/or premature ventricular contractions was determined by activation mapping and pace mapping. Mapping was performed within the CVS if endocardial mapping did not reveal an SOO. Venography of the CVS and coronary angiography were performed before ablation in the CVS. In 27 of 189 patients (14%+/- 5%; 95% confidence interval), the SOO of the ventricular arrhythmia was identified from within the coronary venous system, either in the great cardiac vein (n=26) or the middle cardiac vein (n=1). The mean activation time at the SOO was -29 +/- 8 ms. Twenty of 27 patients (74%) underwent successful ablation within the CVS. Epicardial ventricular arrhythmias displayed a broader R wave in V-1 compared with arrhythmias in the control group (85 ms [interquartile range, 40] versus 65 ms [interquartile range, 95]; P