https://scholars.lib.ntu.edu.tw/handle/123456789/530047
標題: | Value of local electrogram characteristics predicting successful catheter ablation of left- versus right-sided accessory atrioventricular pathways by radiofrequency current | 作者: | JIUNN-LEE LIN Schie, Jen-Tsong Tseng, Chuen-Den WEN-JONE CHEN Cheng, Tin-Fu Tsou, Shi-Sheng Chen, Jin-Jer Tseng, Yung-Zu Lien, Wen-Pin |
關鍵字: | Accessory atrioventricular pathways; Catheter ablation; Local electrogram predictors; Reentrant tachycardia; Wolff-parkinson-white syndrome | 公開日期: | 1995 | 卷: | 86 | 期: | 2 | 起(迄)頁: | 135 | 來源出版物: | Cardiology (Switzerland) | 摘要: | Despite similar guidance by local electrogram criteria, catheter ablation of right-sided accessory atrioventricular (AV) pathways by radiofrequency current has been less effective than that of left-sided ones. In order to elucidate the possible diversities in local clectrosignal crite-ria. we systematically analyzed the morphological and timing characteristics of 215 bipolar local electrograms from catheter ablation sites of 65 left-sided accessory AV pathways and of 356 from those of 37 right-sided ones in 92 consecutive patients with Wolff-Parkinson-White syndrome or AV reentrant tachycardia incorporating concealed accessory AV pathways. After stepwise multivariate analysis, we selected the presence of a possible accessory pathway potential, local ventricular activation preceding QRS complex for 20 ms or more during ventricular insertion mapping, and the local retrograde ventriculoatrial (VA) continuity, local retrograde VA interval ≤50 ms. electrogram stability (left-sided targets only), retrograde accessory pathway potential (right-sided targets only) during atrial insertion mapping, as independent local electrogram predictors for successful ablation of left- and right-sided accessory AV pathways. Combination of all local electrogram predictors could have moderate chance of success (80 and 51%) for the ventricular and atrial insertion ablation of left-sided accessory AV pathways, but only low probability of success (40% in ventricular insertion ablation) or very low sensitivity (12.5% in atrial insertion ablation) for right-sided ones. In conclusion, with the present approach, successful catheter ablation of right-sided accessory AV pathways, compared to left-sided ones, still necessitate a breakthrough in the precision mapping and the efficiency of energy delivery. © 1995 S. Karger AG, Basel. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/530047 https://www.scopus.com/record/display.uri?eid=2-s2.0-0028837444&doi=10.1159%2f000176857&origin=inward&txGid=fd9a67dbc6e0f9278e8f40e8336cc735 |
ISSN: | 0008-6312 | DOI: | 10.1159/000176857 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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