Electroanatomic mapping of entrained and exit zones in patients with repaired congenital heart disease and intra-atrial reentrant tachycardia.
Electroanatomic mapping of entrained and exit zones in patients with repaired congenital heart disease and intra-atrial reentrant tachycardia.
复制标题
修复先天性心脏病和房内折返性心动过速患者的夹带区和退出区的电解剖图。
DOI：
10.1161/01.cir.103.16.2060
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发表时间：
2001
期刊：
影响因子：
37.8
通讯作者：
Walsh,EP
中科院分区：
文献类型：
--
作者：
Triedman,JK;Alexander,ME;Berul,CI;Bevilacqua,LM;Walsh,EP
先天性心脏病（CHD）的房内折返性心动过速（IART）的折返性回路和靶向消融部位的表征仍然很困难。方法和结果：在15例CHD患者成功消融18条IART回路之前进行电解剖标测和夹带起搏。IART回路的主要特征为房间隔缺损（4例）、心房切开（3例）、其他心房瘢痕（3例）、界嵴（3例）和右房室瓣（5例）。中位数为176个位点（范围，96至317个位点）被映射为激活，13个位点（范围，9至28个位点）被映射为夹带反应。将心动过速周期长度20 ms内的起搏后间期和0 - 90 ms的刺激-P波间期（出口区）标测到电解剖标测生成的心房表面。心房表面的中位数为21 cm 2（范围：2 - 75 cm 2），占受试总面积的19%（范围：1%-81%），符合夹带标准。使用集成的数据，激活序列和保护走廊的传导之间的关系可以推断17 IART的16。成功的消融是在一个网站远离假定的保护走廊18（50%）circuit.Conclusions-The右心房冠心病支持各种IART机制。激活和夹带数据的融合提供了对与消融相关的特定IART机制的深入了解。
Background—Characterization of reentrant circuits and targeting ablation sites remains difficult for intra-atrial reentrant tachycardias (IART) in congenital heart disease (CHD).Methods and Results—Electroanatomic mapping and entrainment pacing were performed before successful ablation of 18 IART circuits in 15 patients with CHD. Principal features of IART circuits were atrial septal defect (4 patients), atriotomy (3 patients), other atrial scar (3 patients), crista terminalis (3 patients), and right atrioventricular valve (5 patients). A median of 176 sites (range, 96 to 317 sites) was mapped for activation and 13 sites (range, 9 to 28 sites) for entrainment response. Postpacing intervals within 20 ms of tachycardia cycle length and stimulus–to–P-wave intervals of 0 to 90 ms (exit zones) were mapped to atrial surfaces generated by electroanatomic mapping. Criteria for entrainment were met over a median of 21 cm2of atrial surface (range, 2 to 75 cm2), 19% (range, 1% to 81%) of total area tested. Using integrated data, relations between activation sequence and protected corridor of conduction could be inferred for 16 of 17 IARTs. Successful ablation was achieved at a site distant from the putative protected corridor in 9 of 18 (50%) circuits.Conclusions—The right atrium in CHD supports a variety of IART mechanisms. Fusion of activation and entrainment data provided insight into specific IART mechanisms relevant to ablation.