利用超高密度制图系统研究周期长短交替的大可入心性房性心动过速机制。

Jin-lin Zhang, Liangrong Zheng, Dongchen Zhou, Anquan Zhao, Cheng Tang, Yong-hua Zhang, X. Su
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引用次数: 7

摘要

背景:伴周期长度交替的性心动过速(AT)是一种罕见的现象。我们的目的是利用超高密度制图系统来确定这一特殊类别的ATs的特征和精确机制。方法从2个机构的478个ATs中筛选出7个具有交替CL的ATs。长CL(289±35 ms)时绘制激活图;测图点,21 520±11 103)和短CL(251±18 ms);测绘点分别为17 594±8059)。结果将伴有CL交替的ATs分为2种类型。类型1:存在2个不同路径的潜在环路。CL交替是由较小回路通道内间歇性2:1传导阻滞引起的。2型:CL交替是由先前存在的线状病变内2个紧密间隔的间隙的传导速度不同引起的。导管消融均成功终止7例ATs。结论超高密度成像为准确描述AT与CL交替的机制提供了机会。间歇性传导阻滞或通道减慢对于AT的维持至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Insight Into the Mechanism of Macroreentrant Atrial Tachycardia With Cycle Length Alternans Using Ultrahigh Density Mapping System.
BACKGROUND Atrial tachycardia (AT) with cycle length (CL) alternans is a rare phenomenon. We aimed to identify the characteristics and precise mechanism of this special category of ATs by using an ultrahigh density mapping system. METHODS We identified 7 ATs with alternating CL in a total of 478 ATs from 2 institutions mapped with an ultrahigh density mapping system. Activation maps were performed for long CL (289±35 ms; mapping points, 21 520±11 103) and short CL (251±18 ms; mapping points,17 594±8059) separately. RESULTS We classified ATs with CL alternans into 2 types. Type 1: There existed 2 potential loops with different routes. CL alternans resulted from an intermittently 2:1 conducting block within the channel of the smaller loop. Type 2: CL alternans resulted from different conduction velocity through 2 closely spaced gaps within preexisting linear lesions. Catheter ablation successfully terminated all the 7 ATs. CONCLUSIONS Ultrahigh density mapping provides an opportunity to delineate the precise mechanism of AT with CL alternans. Intermittent conduction block or slowing of a channel was essential for the maintenance of AT.
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