https://scholars.lib.ntu.edu.tw/handle/123456789/188710
標題: | Comparison of Local Electrogram Predictors for Successful Catheter Ablation of Left-Versus Right-Sided Accessory Atrioventricular Pathways by Radiofrequency Current | 作者: | JIUNN-LEE LIN WEN-JONE CHEN Schie Jen-Tsong Tseng Chuen-Den Chen Jin-Jer Tseng Yun-Zu Lien Wen-Pin |
公開日期: | 1-一月-1994 | 卷: | 6 | 期: | 1 | 起(迄)頁: | 47 | 來源出版物: | Biomedical Engineering, Applications Basis Communications | 摘要: | Analysis of local electrogram manifestations is critical to the success of radiofrequency catheter ablation of accessory atrioventricular (AV) pathways. However, despite similar criteria, the ablation of right-sided targets has been less effective than that of left-sided ones. In order to elucidate the possible variations, we systematically analyzed the morphological and timing characteristics of 215 bipolar local electrograms from ablation sites of 65 left-sided accessory AV pathways, and 356 from those of 37 right-sided ones in 92 consecutive patients. By multivariate analysis, we selected the presence of a possible accessory pathway potential, local ventricular activation preceding QRS complex for 20 ms or more (ventricular insertion mapping); and the local retrograde ventriculoatrial continuity, local retrograde ventriculo-atrial interval ≤50 ms (atrial insertion mapping) as the common independent outcome predictors by local electrogram criteria for ablation of left- and right-sided accessory AV pathways. Electrogram stability for left-sided targets and retrograde accessory pathway potential for right-sided ones were additional indicators during atrial insertion ablation. Combination of all local electrogram predictors could have moderate chance of success for ablation of left-sided accessory AV pathways: positive predictive value of 80% and 51% by ventricular and atrial insertion mapping. However, such combination had either low positive predictive value or very low sensitivity in cases of right-sided accessory AV pathways. In conclusion, successful catheter ablation of right-sided accessory AV pathways, as comparing to left-sided ones, necessitated still more breakthrough in addition to local signal analysis. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/126799 https://www.scopus.com/record/display.uri?eid=2-s2.0-0028374462&origin=inward&txGid=370aa3744f4e10cdb3b6f7c66f86c1f9 |
ISSN: | 1016-2356 |
顯示於: | 醫學系 |
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