https://scholars.lib.ntu.edu.tw/handle/123456789/536721
標題: | Use of double-potential barrier to identify functional isthmus at the cavotricuspid isthmus for facilitating catheter ablation of isthmus-dependent atrial flutter | 作者: | LING-PING LAI JIUNN-LEE LIN Lin J.-M. Du C.-C. Tseng Y.-Z. Huang S.K.S. |
關鍵字: | Atrial flutter; Catheter ablation; Cavotricuspid isthmus; Navigated magnetic mapping | 公開日期: | 2004 | 卷: | 15 | 期: | 4 | 起(迄)頁: | 396-401 | 來源出版物: | Journal of Cardiovascular Electrophysiology | 摘要: | Introduction: The aim of the study was to identify an alternative target for more effective radiofrequency catheter ablation (RFCA) of isthmus-dependent atrial flutter (AFL). Methods and Results: We hypothesized that a functional isthmus formed by preexisting double potential barrier at the cavotricuspid isthmus (CTI) could serve as a new target site for facilitating RFCA of AFL. Forty-three consecutive patients with recurrent isthmus-dependent AFL were studied using three-dimensional navigated magnetic mapping and ablation technique. Twenty patients (47%, group A) were shown to have a narrower functional channel at the CTI (functional isthmus). The remaining 23 patients did not have this feature (53%, group B). In group A, double potentials were clustered near the border of the inferior vena cava (IVC) of the CTI and served as a functional channel along the tricuspid annulus (TA). The interspike interval of double potentials was 87 ± 26 ms near the IVC border and 45 ± 17 ms (P < 0.0001) near the TA border of CTI. RFCA targeting at the functional isthmus in group A resulted in interruption of bidirectional transisthmus conduction with fewer radiofrequency pulses (6.7 ± 4.7 in group A vs 21.1 ± 17.1 pulses in group B, P < 0.001), shorter ablation line (11.6 ± 4.0 mm vs 37.8 ± 7.2 mm, P < 0.0001) with no arrhythmia recurrence. These functional isthmuses were found to be located at the lateral third of CTI in 12 patients, middle third in 7, and medial third in 1. This finding is different from that obtained by the conventional method in group B (lateral in 5, middle in 16, medial in 2, P < 0.038). Conclusion: In our study, a functional, rather than anatomic, isthmus formed by preexisting double-potential barrier at the CTI was identified in 47% of patients with isthmus-dependent AFL. It is a useful guide to facilitate RFCA of isthmus-dependent AFL. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-1942504688&doi=10.1046%2fj.1540-8167.2004.03424.x&partnerID=40&md5=99042628c3fe0234c4a998db67c82a9a https://scholars.lib.ntu.edu.tw/handle/123456789/536721 |
ISSN: | 1045-3873 | DOI: | 10.1046/j.1540-8167.2004.03424.x | SDG/關鍵字: | adult; aged; article; catheter ablation; clinical feature; controlled study; female; heart atrium flutter; human; inferior cava vein; male; priority journal; pulse rate; radiofrequency; recurrent disease; tricuspid valve; Atrial Flutter; Catheter Ablation; Electrophysiologic Techniques, Cardiac; Female; Follow-Up Studies; Humans; Imaging, Three-Dimensional; Male; Middle Aged; Recurrence; Tricuspid Valve; Vena Cava, Inferior |
顯示於: | 醫學系 |
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