Termination of macroreentrant atrial arrhythmias by pacing stimuli without global propagation
Heart Rhythm(2022)
摘要
BACKGROUND Electrical stimulation during ventricular tachycardia resulting in tachycardia termination without global propagation (TWGP) is a well-recognized phenomenon. However, there is a paucity of literature showing a similar phenomenon in atrial arrhythmias. OBJECTIVE The purpose of the study was to evaluate the significance of TWGP in atrial arrhythmias. METHODS Electrophysiological studies performed from 2000 to 2019 at Methodist Hospital, Indiana University were reviewed retrospectively. Thirty-four patients were identified in whom stimulation during atrial tachycardia/flutter resulted in TWGP. RESULTS Of the 34 patients, 12 (29%) had cavotricuspid isthmus (CTI)-dependent atrial flutter and 22 (71%) had other atrial arrhythmias during which TWGP was seen. Mean age of the population was 53 6 13 years; and 68% were male. Previous catheter ablation for atrial fibrillation, atrial flutter, or other atrial tachyarrhythmias had been performed in 70.5%, and 44% previously had undergone cardiac surgery involving the atria. Congenital heart disease was present in 20.5%; 3 patients were status post lung transplant. Mean cycle length of atrial arrhythmia in which TWGP was seen was 317 +/- 76 ms. The sites at which TWGP was seen reproducibly were highly specific for successful termination of the arrhythmias with radiofrequency energy. The arrhythmia circuits were 12 CTI-dependent atrial flutter, 11 left atrial macroreentrant atrial tachycardia (MRAT), 1 involving both left and right atria, and 8 were other right atrial MRAT. CONCLUSION Termination of macroreentrant atrial arrhythmias by pacing stimuli without global propagation identifies a narrow diastolic isthmus at which catheter ablation is highly effective.
更多查看译文
关键词
Atrial flutter,Cavotricuspid isthmus,Macroreentrant atrial tachycardia,Termination without global propagation,Ventricular tachycardia
AI 理解论文
溯源树
样例
![](https://originalfileserver.aminer.cn/sys/aminer/pubs/mrt_preview.jpeg)
生成溯源树,研究论文发展脉络
Chat Paper
正在生成论文摘要