Ventricular Arrhythmias Ablated From the Noncoronary Aortic Sinus: Underrecognized Myocardium of the Right Ventricle.
Ventricular Arrhythmias Ablated From the Noncoronary Aortic Sinus: Underrecognized Myocardium of the Right Ventricle.
复制标题
从非冠状动脉主动脉窦消融的室性心律失常：右心室心肌的认识不足。
DOI：
10.1016/j.jacep.2023.04.024
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Bradfield,JasonS
中科院分区：
文献类型：
--
作者：
Mori,Shumpei;Bradfield,JasonS
室性心律失常可以通过导管消融在非冠状动脉主动脉窦内靶向已经报道了20多年前。1-4与可通过导管消融右或左冠状动脉主动脉窦消除室性心律失常相比，非冠状动脉主动脉窦消融室性心律失常的频率较低。在这一期的《JACC：临床电生理学》中，Liao等人5通过详细的电生理观察，包括在最早的心室激活部位记录的离散电位，对这种罕见的实体进行了重新评估。尽管文献中有多个病例，但1-4这一实体令人费解，因为解剖学背景尚未得到很好的理解。如图1A和1C所示，从左心室心内膜表面观察解剖标本4,5可以看出，非冠状动脉主动脉窦不受心室心肌的支撑。相反，在左右冠状动脉处可见支撑主动脉根的心室心肌
Ventricular arrhythmias that can be targeted by catheter ablation within the noncoronary aortic sinus have been reported more than 20 years ago. 1-4 Compared with ventricular arrhythmias that can be eliminated by catheter ablation within the right or left coronary aortic sinuses, the frequency of ventricular arrhythmias ablated form the noncoronary aortic sinus is low. 1, 2, 4 In this issue of JACC: Clinical Electrophysiology, Liao et al 5 provided reappraisal of this rare entity with detailed electrophysiologic observations including discrete potentials recorded at the earliest ventricular activation site.Despite multiple cases in the literature, 1-4 this entity is puzzling, as the anatomical background is not well understood. As generally demonstrated in anatomical specimens viewed from the left ventricular endocardial surface, 4, 5 as shown in Figures 1A and 1C, the noncoronary aortic sinus is not supported by the ventricular myocardium. In contrast, ventricular myocardium supporting the aortic root is found at the right and left coronary