Right Pulmonary Vein Potentials Recorded from the Posterior Right Atrial Endocardium: Human Case Report and Validation in a Porcine Model
Right Pulmonary Vein Potentials Recorded from the Posterior Right Atrial Endocardium: Human Case Report and Validation in a Porcine Model
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右心房后心内膜记录的右肺静脉电位：人类病例报告和猪模型验证
DOI：
10.1111/j.1540-8167.2000.tb01803.x
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发表时间：
2000
影响因子：
2.7
通讯作者：
D. Schwartzman
中科院分区：
文献类型：
--
作者：
D. Schwartzman
右心房的肺静脉电位。一名 33 岁女性成功接受了导管消融术，治疗源自右上肺大静脉 (RSPV) 深处的房性心动过速。该患者之前的一次消融尝试失败了，射频能量仅应用于右心房后部。这种心动过速的右心房来源的错误印象是由于在右心房后部邻近静脉的区域（“邻近区域”）测绘过程中记录的 RSPV 电位所致。为了进一步评估这一点，我们对健康猪的心房进行了激活映射和射频消融。与报告的情况类似，从邻近区域的左侧和右侧记录了“双心”电位。射频能量的应用仅改变了病变所在心房发出的电位。组织学分析证实病变仅限于该心房。结论是，由于它们很接近，RSPV 中的电活动可以从右心房后部的某些区域记录下来，反之亦然。在报告的左房性心动过速病例中，这导致了右房性心动过速的错误印象。
Pulmonary Vein Potentials in Right Atrium. A 33‐year‐old woman underwent successful catheter ablation of an atrial tachycardia emanating from deep within a large right superior pulmonary vein (RSPV). A previous ablation attempt in this patient had failed, during which radiofrequency energy applications were made to the posterior right atrium only. The mistaken impression of a right atrial source for this tachycardia was due to RSPV potentials that were recorded during mapping in a region of the posterior right atrium contiguous to the vein (“contiguity region”). To further evaluate this, we performed activation mapping and radiofrequency ahlation in atria of healthy pigs. Similar to the reported case, “biatrial” potentials were recorded from both left and right aspects of the contiguity region. Radiofrequency energy application altered only the potential emanating from the atrium in which the lesion was applied. Histologic analysis confirmed that the lesion was limited to this atrium. It is concluded that, due to their proximity, electrical activity in the RSPV may be recorded from certain areas of the posterior right atrium, and vice versa. In the reported case of left atrial tachycardia, this led to the mistaken impression of right atrial tachycardia.