Document Detail


Change in distant atrial activation patterns during circumferential pacemapping of pulmonic vein ostium: implications for localizing triggers for atrial fibrillation.
MedLine Citation:
PMID:  12815304     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Unique intracardiac activation patterns recorded from multipolar catheters in the coronary sinus (CS) and posteromedial right atrium (RA) when pacing from ostium (os) of each pulmonic vein (PV) can serve as template for determining PV of origin of atrial premature complexes. Development of an accurate template requires knowledge of variations in activation pattern during pacing from different aspects of same PV. METHODS: In 25 patients undergoing catheter ablation for AF, a decapolar Lasso mapping catheter was placed at PV os of interest and multipolar catheters were placed in CS and RA-medial to crista terminalis (CT). For each PV, pacing was performed from Lasso catheter poles 1 through 10. For each bipole paced, activation sequence in CS (proximal to distal & vice-versa) was assessed, activation time (pacing stimulus to earliest electrogram recorded in catheters in CS/along CT) was measured and difference (CS - CT time) was determined. Significant interpolar variation was defined as the difference between the shortest and longest CS - CT activation time of >/=25 msec when pacing from different bipoles of same PV. RESULTS:In 59 PVs [19 right superior (RS), 20 left superior (LS), 8 right inferior (RI) and 12 left inferior (LI)], 259 bipoles were paced (median of 4 bipoles/PV). During circumferential PV pacing activation sequence in CS catheter was distal to proximal in 84.4% left-sided PVs (LSPV and LIPV) and proximal to distal in 92.6% right-sided PVs (RSPV and RIPV) with no change in activation sequence observed during pacing from different bipoles in same PV. Significant interpolar variation was observed with circumferential pacing in 1 of 19 RSPV (5.3%), 2 of 20 LSPV (10%), 1 of 12 LIPV (8.3%) and none of RIPV. CONCLUSION: Unique intracardiac activation patterns during ostial pacing from individual PV are not influenced by circumferential location of pacing site.
Authors:
Sanjay Dixit; Edward P Gerstenfeld; Robert W Rho; Vickas Patel; David J Callans; Francis E Marchlinski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  8     ISSN:  1383-875X     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2003 Jun 
Date Detail:
Created Date:  2003-06-19     Completed Date:  2003-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  187-94     Citation Subset:  IM    
Affiliation:
University of Pennsylvania Health System, Philadelphia, PA 19104, USA.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / diagnosis*,  physiopathology
Cardiac Pacing, Artificial
Catheter Ablation
Coronary Vessels / physiopathology
Electrophysiologic Techniques, Cardiac / methods*
Heart Catheterization
Heart Conduction System
Humans
Middle Aged
Pulmonary Veins / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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