Understanding electrical pulmonary vein antrum for paroxysmal atrial fibrillation: Further look into superhigh-density electroanatomic mapping of the left atrium.
Jingcheng Chen, Gang Yang, Chang Cui, Weizhu Ju, Hailei Liu, Mingfang Li, Hongwu Chen, Kai Gu, Zidun Wang, Minglong Chen
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引用次数: 0
Abstract
Background: An isolation line placed at the pulmonary vein antrum (PVA) area is superior to ostium level in atrial fibrillation (AF) control. However, less is known about the electrophysiologic characteristics of the PVA.
Objective: The aim of this study was to describe the electrophysiologic properties of the PVA.
Methods: High-density mapping of the left atrium was performed in 18 paroxysmal AF (PAF) patients and 9 age- and sex-matched paroxysmal supraventricular tachycardia (PSVT) patients. Each PVA was divided into 8 segments, and the pulmonary vein (PV) was divided into 4 segments. The electrophysiologic properties included slow conduction, complex fractionated electrograms, and effective refractory period (ERP).
Results: Slow conduction was more prevalent at the PVA (43.2% ± 19.5% vs 14.7% ± 13.0%; P = .001) and PV (61.9% ± 16.4% vs 9.1% ± 9.0%; P < .001) in PAF patients than in PSVT patients during sinus rhythm. Similarly, the area with complex fractionated electrograms was significantly larger at the PVA (133.8 [61.6-233.2] mm2 vs 0.0 [0.0-41.4] mm2; P = .011) in PAF patients during sinus rhythm. The ERP of the PVA was longer in PAF patients than in control at the drive length of 600 ms (260 [230-280] ms vs 220 [190-250] ms; P = .001) and 400 ms (230 [205-250] ms vs 200 [190-220] ms; P = .007). The ERP net difference between the PV and PVA is larger in PAF patients than in control both at 600-ms pacing (40 [20-70] ms vs 10 [10-30] ms; P < .001) and at 400-ms pacing (40 [20-60] ms vs 20 [10-30] ms; P < .001).
Conclusion: PAF patients have the PVA electrical substrate including slow conduction, complex fractionated electrograms, and ERP dispersion.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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