|Title:||Global Distribution of Atrial Ectopic Foci Triggering Recurrence of Atrial Tachyarrhythmia after Electrical Cardioversion of Long-Standing Atrial Fibrillation: A Bi-Atrial Basket Mapping Study
長期心房顫動經電擊 成功後，再復發心房快速不整脈之誘發心房異位病灶之空間分佈：雙心房籃網電極定 位研究
HUANG, SHOEI-K STEPHEN
|Keywords:||Atrial fibrillation;Atrial mapping;Atrial ectopic beat;Antiarrhythmic drug;Electrical cardioversion||Issue Date:||2001||Journal Volume:||v.37||Journal Issue:||n.3||Start page/Pages:||904-910||Source:||JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY||Abstract:||
Objectives. To assess the spatial distribution of atrial ectopic foci potentially triggering recurrent atrial tachyarrhythmias after electrical cardioversion of long- standing atrial fibrillation. Background. Whether targeted ablation of atrial ectopic foci concentrated in the pulmonary veins is feasible in patients with long-standing atrial fibrillation, as such ablation is for those paroxysmal, remains unknown. Methods. Two basket electrodes( 32 bipoles on each 8 splines) were positioned in the right and left atrium to identify the earliest endocardial activation sites of atrial ectopic foci emerging immediately after external electrical cardioversion of long-standing atrial fibrillation, before and after intravenous administration of dl-sotalol (16 patients) and propafenone ( 16 patients). Results. Before the use of antiarrhythmics, 91 distinct atrial ectopic foci were recognized after cardioversion. In 69 of the 91 foci, the earliest sites of presystolic atrial activation could be identified. Left atrial posterior (16 foci), left atrial anterior (11 foci) and right atrial posterior regions (13 foci) appeared to be prevalent. However, atrial ectopies from the remaining atrial regions (29 foci) were not uncommon. After adding dl- sotalol or propafenone, only 64 atrial ectopic foci were recognized after cardioversion; 50 of those were identifiable at the earliest activation sites. The scattered pattern of spatial distribution of the atrial ectopic foci was virtually unchanged. Conclusions. Atrial ectopic foci potentially triggering the recurrence of atrial tachyarrhythmias after successful electrical cardioversion of long- standing atrial fibrillation were scattered in spatial distribution and multiple in production, possibly rendering difficult the targeted ablation approach.
|Appears in Collections:||醫學系|
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