A simple pacing maneuver to unmask an epicardial connection involving the right‐sided pulmonary veins.
Introduction: An epicardial connection (EC) between the right‐sided pulmonary venous (PV) carina and right atrium (RA) is one of the mechanisms for which carinal ablation is required for right‐sided PV isolation. The purpose of the study was to devise a simple pacing maneuver to differentiate an EC...
| Publicado en: | Journal of Cardiovascular Electrophysiology Vol. 32; no. 2; pp. 287 - 297 |
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| Autores principales: | , , , , , , |
| Formato: | pictorial research tables/charts tracings Journal Article |
| Publicado: |
Wiley-Blackwell
Feb2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=148652602&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 148652602 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10453873 GSB jtl: Journal of Cardiovascular Electrophysiology issn: 10453873 maglogo: Y pubinfo: dt: Feb2021 vid: 32 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 148652602 147692891 148652602 148652602 10.1111/jce.14835 148652602 ppf: 287 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: A simple pacing maneuver to unmask an epicardial connection involving the right‐sided pulmonary veins. aug: au: Hasebe, Hideyuki Yoshida, Kentaro Nogami, Akihiko Furuyashiki, Yoshitaka Hanaki, Yuichi Baba, Masako Ieda, Masaki affil: Department of Cardiology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan sug: subj: Pulmonary Veins Catheter Ablation Methods Heart Atrium Physiology Heart Atrium Anatomy and Histology Human Electrophysiology Atrial Fibrillation Cardiac Pacing, Artificial Descriptive Statistics Mann-Whitney U Test T-Tests Chi Square Test Data Analysis Software Male Female Middle Age Aged Electrodes, Implanted Electrocardiography Methods Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Introduction: An epicardial connection (EC) between the right‐sided pulmonary venous (PV) carina and right atrium (RA) is one of the mechanisms for which carinal ablation is required for right‐sided PV isolation. The purpose of the study was to devise a simple pacing maneuver to differentiate an EC from a residual conduction gap on the antral ablation line during radiofrequency catheter ablation. Methods and Results: This study included 133 consecutive patients. After one round of ablation, electrograms at the posterior antrum outside the ablation line were recorded during sinus rhythm (SR) and coronary sinus (CS) pacing, and intervals between the antral and PV potentials were measured in each rhythm. The ΔintervalSR‐CS was calculated as the difference between the interval during SR and that during CS pacing. Presence of an EC was confirmed by observation of a RA posterior wall breakthrough during right‐sided PV pacing, which was then targeted for ablation. Patients with nonachievement of first‐pass isolation (N = 35) and with PV reconnection during the procedure (N = 9) were classified into the EC‐group (N = 20) and gap‐group (N=24), respectively. The prevalence of carina breakthrough during SR was higher in the EC‐group than the gap‐group (18 [95%] vs. 1 [4%] patients, p <.0001). The ΔintervalSR‐CS was larger in the EC‐group versus gap‐group (71 [interquartile range, 57–97] vs. 6 [2–9] ms, p <.0001). In all patients with an EC, RA ablation resulted in delay (32 [20–40] ms) (N = 15) or elimination of PV potentials (N = 5). Conclusion: An EC can be efficiently discriminated from a conduction gap by a simple pacing maneuver. pubtype: Academic Journal doctype: pictorial research tables/charts tracings Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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