多种房性心动过速患者功能性传导阻滞的特征--关于多种房性心动过速机制的讨论。

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Interventional Cardiac Electrophysiology Pub Date : 2024-11-01 Epub Date: 2024-05-21 DOI:10.1007/s10840-024-01817-8
Bin Zhu, GuoHua Zhang, SongCai Xie, Ying Luan, Wei Cao, Jian Xu, Shuo Zhang, JinWei Tian, Fan Wang, ShuFeng Li
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引用次数: 0

摘要

背景:高分辨率制图在描述传导特征方面具有更高的准确性;然而,某些特征仍与房性心动过速(AT)复发率升高有关,这表明还存在其他机制的影响。本研究系统评估了功能性传导阻滞(FCB)区域的基底与多发性房性心动过速机制的关系:在这项研究中,Carto 系统为 13 名接受消融术的患者绘制了心房颤动图,每名患者都有两种以上的心房颤动变异。对 FCB 区域进行了标记和进一步分析:结果:在所有患者中,共绘制出 33 个持续性 AT。13 名患者中有 7 名(54%)的 FCB 区域显示出可转换性。FCB 区域可归纳出三种表现形式:首先,FCB 区域可能是维持局部再电位通路的主要障碍,其迂回显然与 AT 的机制直接相关(27%)。其次,FCB 区可能是局部 AT 和大再发 AT 中重组再入传播的障碍线(55%)。最后,FCB 区域可能是旁观者,可能与 AT 的机制无关(18%)。FCB区域的电位大多在AT中表现为低电压或碎裂电位(FPs),但它们并不表现为传导阻滞(90%):结论:在多房室传导阻滞中,FCB区域并不少见。FCB区域在ATs机制中的参与显示出三种不同的表现。这种基质的动态性质可能有助于了解相关 ATs 复发率高的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The characterization of functional conduction block in patients with multiple types of atrial tachycardia- A discussion on the mechanism of multiple atrial tachycardia.

Background: High-resolution mapping offers superior accuracy in delineating conduction features; however, certain characteristics are still linked to elevated recurrence rates of atrial tachycardia (AT), suggesting the influence of additional mechanisms. This study systematically assessed the substrate of functional conduction block (FCB) regions in relation to the mechanisms of multiple ATs.

Methods: In this study, the Carto system facilitated the mapping of ATs in 13 patients undergoing ablation, each presenting with more than two AT variants. FCB regions were marked and further analyzed.

Results: A total of 33 sustained ATs were mapped across the patient cohort. FCB regions showed convertibility in 7 of 13 patients (54%). Three kinds of presentations can be summarized by the FCB region: Firstly, the FCB region could act as the main obstacle sustaining the localized reentrant pathway, for which rounding obviously has a direct correlation with the mechanism of the AT (27%). Secondly, the FCB regions could act as obstacle lines to reorganize the propagation of the reentry in localized AT and macroreentrant AT (55%). Lastly, the FCB region could act as a bystander and may not be related to the mechanism of the ATs (18%). The potentials in FCB regions mostly performed low voltages or fragmented potentials (FPs) in the ATs which they did not perform the conduction block (90%).

Conclusion: In multiple ATs, FCB regions may not be uncommon. The participation of FCB regions in the mechanism of ATs showed three different kinds of performance. The dynamic nature of this substrate may provide insight into the reasons for the high recurrence of related ATs.

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来源期刊
CiteScore
4.30
自引率
11.10%
发文量
320
审稿时长
4-8 weeks
期刊介绍: The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.
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