| Lessons from dissociated pulmonary vein potentials: entry block implies exit block. | |
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MedLine Citation:
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PMID: 23275474 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIMS: Prior reports using pacing manoeuvres, demonstrated an up to 42% prevalence of residual pulmonary vein to left atrium (PV-LA) exit conduction after apparent LA-PV entry block. We aimed to determine in a two-centre study the prevalence of residual PV-LA exit conduction in the presence of unambiguously proven entry block and without pacing manoeuvres.METHODS AND RESULTS: Of 378 patients, 132 (35%) exhibited spontaneous pulmonary vein (PV) potentials following circumferential PV isolation guided by three-dimensional mapping and a circular mapping catheter. Pulmonary vein automaticity was regarded as unambiguous proof of LA-PV entry block. We determined the prevalence of spontaneous exit conduction of the spontaneous PV potentials toward the LA. Pulmonary vein automaticity was observed in 171 PVs: 61 right superior PV, 33 right inferior PV, 47 left superior PV, and 30 left inferior PV. Cycle length of the PV automaticity was >1000 ms in all cases. Spontaneous PV-LA exit conduction was observed in one of 171 PVs (0.6%). In a subset of 69 PVs, pacing from within the PV invariably confirmed PVLA exit block.CONCLUSION: Unidirectional block at the LA-PV junction is unusual (0.6%). This observation is supportive of LA-PV entry block as a sufficient electrophysiological endpoint for PV isolation. |
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Authors:
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Mattias Duytschaever; Grim De Meyer; Marta Acena; Milad El-Haddad; Yves De Greef; Frederic Van Heuverswyn; Yves Vandekerckhove; Rene Tavernier; Geoffrey Lee; Peter Kistler |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-28 |
Journal Detail:
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Title: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology Volume: - ISSN: 1532-2092 ISO Abbreviation: Europace Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100883649 Medline TA: Europace Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Cardiology, St Jan Hospital Bruges, Ruddershove 10, 8000 Bruges, Belgium. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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