Document Detail


A simple method of mapping atrial premature depolarizations triggering atrial fibrillation.
MedLine Citation:
PMID:  11227964     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Atrial premature depolarizations (APDs) originating from focal sites, particularly the pulmonary veins (PV), may become triggers of atrial fibrillation (AF). Accurate mapping of APDs with conventional methods may be time consuming and expose the patient to unnecessary instrumentation of the left atrium. We hypothesized that the atrial activation sequence recorded using a simple system that includes an esophageal catheter and a custom-made 16-electrode catheter with two sets of floating electrodes eight in the coronary sinus and eight in the high right atrium) could be sufficient to localize the APDs. The study included 29 patients with frequent APDs and AF refractory to antiarrhythmic medications. The APD site of origin was confirmed with single-point sequential mapping techniques using the CARTO system ten patients) or by placement of multielectrode catheters in the right and left PV (19 patients). Of the 29 patients, 20 patients had a single APD focus; 8 patients had two different APD morphologies; and 1 patient had three APD foci. Mapping for ablation of the APD foci showed earliest activation in the left superior PV in 12 patients, right superior PV in 15 patients, right middle PV in 4 patients, right inferior PV in 1 patient, the lingular branch of the left superior PV in 2 patients, left inferior PV in 2 patients, and right atrium along the crista terminalis in 3 patients. The activation sequence and relative timing of the recordings obtained with our catheter configuration was highly predictive of right and left atrial origin and, more importantly, of right and left PV foci.
Authors:
R A Schweikert; A Perez Lugones; L Kanagaratnam; G Tomassoni; S Beheiry; D Bash; E Pisano; W Saliba; P J Tchou; A Natale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  24     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2001 Jan 
Date Detail:
Created Date:  2001-02-28     Completed Date:  2001-05-31     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-7     Citation Subset:  IM    
Affiliation:
Cleveland Clinic Foundation, 9500 Euclid Ave., Desk F-15, Cleveland, OH 44195, USA.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / etiology*
Atrial Premature Complexes / complications,  diagnosis*
Catheterization
Electrophysiologic Techniques, Cardiac / methods*
Esophagus
Female
Heart Catheterization / methods
Humans
Male
Middle Aged
Pulmonary Veins

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


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