Biatrial multisite mapping of atrial premature complexes triggering onset of atrial fibrillation
Biatrial multisite mapping of atrial premature complexes triggering onset of atrial fibrillation
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DOI：
10.1016/s0002-9149(02)02350-0
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发表时间：
2002-06-15
影响因子：
2.8
通讯作者：
Schömig, A
中科院分区：
文献类型：
--
作者：
Schmitt, C;Ndrepepa, G;Schömig, A
肺静脉被认为是诱发心房颤动（AF）的局灶性活动最常见的来源。然而，对于位于肺静脉外的异位活动的重要性知之甚少。本研究纳入了45例阵发性房颤（n = 25）和持续性房颤（n = 20）患者（8名女性和37名男性，平均年龄55 - 12岁），其中使用64电极篮式导管（n = 21）或非接触式房颤定位系统（n = 24）对左右心房进行多位点定位。自发性或奥昔那林诱导的心房过早复合物（APCs）被绘制。总共观察和分析了30例患者中来自38个不同病灶的94例房颤发作。其中20例（53%）位于肺静脉内，18例（47%）位于心房其他部位肺静脉外。在22例（73%）患者中，单灶APCs可重复诱导AF（59次）。8例患者（27%）AF起源于2个不同的病灶（35次发作）。此外，30例发生房颤的患者中有20例（67%）在不同部位有apc，但未诱发房颤。apc诱导房颤的偶联时间间隔比apc未诱发房颤的偶联时间短(307 +/- 54 ms vs 409 +/- 76 ms, p
Pulmonary veins are considered to be the most common origin of the focal activity that triggers the onset of atria] fibrillation (AF). However, little is known about the importance of ectopic activity located outside the pulmonary veins. This study included 45 patients (8 women and 37 men, mean age 55 12 years) with paroxysmal (n = 25) and persistent (n = 20) AF in whom multisite mapping of the right and left atria was performed using a 64-electrode basket catheter (n = 21) or a noncontact mapping system (n = 24). Spontaneous or orciprenaline-induced atrial premature complexes (APCs) were mapped. In all, 94 AF onsets from 38 distinct foci in 30 patients were observed and analyzed. Of these foci, 20 (53%) were located in pulmonary veins and 18 (47%) were located outside the pulmonary veins in other parts of the atria. In 22 patients (73%), AF was reproducibly induced by APCs from a single focus (59 episodes). In 8 patients (27%), AF originated from 2 distinct foci (35 episodes). Additionally, 20 of 30 patients (67%) who developed AF had APCs in different locations not inducing AF. APCs inducing AF had shorter coupling intervals than APCs not inducing AF (307 +/- 54 vs 409 +/- 76 ms, p