Use of intraoperative mapping to optimize surgical ablation of atrial flutter.
Use of intraoperative mapping to optimize surgical ablation of atrial flutter.
复制标题
使用术中标测来优化心房扑动的手术消融。
DOI：
10.1016/0003-4975(93)91172-j
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发表时间：
1993
期刊：
影响因子：
--
通讯作者：
Cox,JL
中科院分区：
文献类型：
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作者：
Yamauchi,S;Schuessler,RB;Kawamoto,T;Shuman,TA;Boineau,JP;Cox,JL
本研究的目的是使用术中激动序列标测开发房扑的外科治疗，以最大限度地减少消融房扑所需的外科手术。通过建立从左锁骨下动脉到左上级肺静脉的分流建立左心房扩大的犬模型（n = 10）。该模型易诱发持续性心房扑动。扑动由一个折返环组成，该折返环围绕一个或两个由功能阻滞区域连接的解剖障碍物旋转。使用由252个双极电极组成的心外膜模板记录激动时间标测图。在确定折返环路的位置后，放置手术切口以中断通路。在所有10只动物中，可诱导扑动，术中标测定位折返回路。7个回路位于右心房，3个位于左心房。手术消融了所有术前回路。然而，在5只动物中，可以诱导源自新回路的扑动。手术前后的激动序列标测显示，在该犬心房颤动模型中存在多条潜在的折返通路。因此，必须手术阻断所有可能的通路，以防止诱发房扑。
The purpose of this study was to develop a surgical treatment for atrial flutter using intraoperative activation sequence mapping to minimize the surgical procedure necessary to ablate the flutter. A canine model (n = 10) of left atrial enlargement was developed by creating a shunt from the left subclavian artery to the left superior pulmonary vein. Sustained atrial flutter was easily induced in this model. The flutter consisted of a single reentrant circuit that rotated around one or two anatomic obstacles linked by a region of functional block. Epicardial templates, consisting of 252 bipolar electrodes, were used to record activation time maps. After localization of the reentrant circuit, surgical incisions were placed to interrupt the pathways. In all 10 animals, flutter could be induced and intraoperative mapping localized the reentrant circuit. Seven circuits were in the right atrium and three were in the left atrium. The operation ablated all of the preoperative circuits. However, in 5 of the animals, flutter originating from a new circuit could be induced. Activation sequence mapping before and after operation demonstrates that there are multiple potential reentrant pathways in this canine model of atrial futter. Therefore, all potential pathways must be surgically interrupted to prevent inducibility of atrial flutter.