Jingcheng Chen, Gang Yang, Chang Cui, Weizhu Ju, Hailei Liu, Mingfang Li, Hongwu Chen, Kai Gu, Zidun Wang, Minglong Chen
{"title":"了解阵发性心房颤动的肺静脉电窦道：进一步了解左心房超高密度电解剖图。","authors":"Jingcheng Chen, Gang Yang, Chang Cui, Weizhu Ju, Hailei Liu, Mingfang Li, Hongwu Chen, Kai Gu, Zidun Wang, Minglong Chen","doi":"10.1016/j.hrthm.2024.09.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Isolation line placed at the pulmonary vein antrum (PVA) area is superior to ostium level in atrial fibrillation (AF) control. However, less is known about the electrophysiological characteristics of PVA.</p><p><strong>Objective: </strong>To describe the electrophysiological properties of PVA.</p><p><strong>Methods: </strong>High-density mapping of the left atrium was performed in 18 paroxysmal AF (PAF) patients and 9 age- and sex-matched paroxysmal supraventricular tachycardia (PSVT) patients. Each PVA was divided into 8, pulmonary vein (PV) into 4 segments. The electrophysiological properties included slow conduction, complex fractionated electrograms, and effective refractory period (ERP).</p><p><strong>Results: </strong>The slow conduction was more prevalent at PVA (43.2±19.5 vs. 14.7±13.0 %, P=0.001) and PV (61.9±16.4 vs. 9.1±9.0 %, P<0.001) in PAF patients than in PSVT patients during sinus rhythm (SR). Similarly, the area with complex fractionated electrograms was significantly larger at PVA (133.8 [61.6, 233.2] vs. 0.0 [0.0, 41.4] mm<sup>2</sup>, P=0.011) in PAF patients during SR. The ERP of PVA was longer in PAF patients than in control at the drive length of 600 ms (260 [230, 280] vs. 220 [190, 250] ms, P=0.001) and 400 ms (230 [205, 250] vs. 200 [190, 220] ms, P=0.007). The ERP net difference between the PV and PVA is larger in PAF patients than in control both at 600 ms (40 [20, 70] vs. 10 [10, 30] ms, P<0.001) and (40 [20, 60] vs. 20 [10, 30] ms, P<0.001) at 400 ms pacing, respectively.</p><p><strong>Conclusion: </strong>PAF patients have the PVA electrical substrate including slow conduction, complex fractionated electrograms and ERP dispersion.</p>","PeriodicalId":12886,"journal":{"name":"Heart rhythm","volume":null,"pages":null},"PeriodicalIF":5.6000,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Understanding electrical pulmonary vein antrum for paroxysmal atrial fibrillation: Further look into super high-density electroanatomic mapping of the left atrium.\",\"authors\":\"Jingcheng Chen, Gang Yang, Chang Cui, Weizhu Ju, Hailei Liu, Mingfang Li, Hongwu Chen, Kai Gu, Zidun Wang, Minglong Chen\",\"doi\":\"10.1016/j.hrthm.2024.09.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Isolation line placed at the pulmonary vein antrum (PVA) area is superior to ostium level in atrial fibrillation (AF) control. However, less is known about the electrophysiological characteristics of PVA.</p><p><strong>Objective: </strong>To describe the electrophysiological properties of PVA.</p><p><strong>Methods: </strong>High-density mapping of the left atrium was performed in 18 paroxysmal AF (PAF) patients and 9 age- and sex-matched paroxysmal supraventricular tachycardia (PSVT) patients. Each PVA was divided into 8, pulmonary vein (PV) into 4 segments. The electrophysiological properties included slow conduction, complex fractionated electrograms, and effective refractory period (ERP).</p><p><strong>Results: </strong>The slow conduction was more prevalent at PVA (43.2±19.5 vs. 14.7±13.0 %, P=0.001) and PV (61.9±16.4 vs. 9.1±9.0 %, P<0.001) in PAF patients than in PSVT patients during sinus rhythm (SR). Similarly, the area with complex fractionated electrograms was significantly larger at PVA (133.8 [61.6, 233.2] vs. 0.0 [0.0, 41.4] mm<sup>2</sup>, P=0.011) in PAF patients during SR. The ERP of PVA was longer in PAF patients than in control at the drive length of 600 ms (260 [230, 280] vs. 220 [190, 250] ms, P=0.001) and 400 ms (230 [205, 250] vs. 200 [190, 220] ms, P=0.007). The ERP net difference between the PV and PVA is larger in PAF patients than in control both at 600 ms (40 [20, 70] vs. 10 [10, 30] ms, P<0.001) and (40 [20, 60] vs. 20 [10, 30] ms, P<0.001) at 400 ms pacing, respectively.</p><p><strong>Conclusion: </strong>PAF patients have the PVA electrical substrate including slow conduction, complex fractionated electrograms and ERP dispersion.</p>\",\"PeriodicalId\":12886,\"journal\":{\"name\":\"Heart rhythm\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.6000,\"publicationDate\":\"2024-09-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart rhythm\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.hrthm.2024.09.014\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart rhythm","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hrthm.2024.09.014","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Understanding electrical pulmonary vein antrum for paroxysmal atrial fibrillation: Further look into super high-density electroanatomic mapping of the left atrium.
Background: Isolation line placed at the pulmonary vein antrum (PVA) area is superior to ostium level in atrial fibrillation (AF) control. However, less is known about the electrophysiological characteristics of PVA.
Objective: To describe the electrophysiological properties of PVA.
Methods: High-density mapping of the left atrium was performed in 18 paroxysmal AF (PAF) patients and 9 age- and sex-matched paroxysmal supraventricular tachycardia (PSVT) patients. Each PVA was divided into 8, pulmonary vein (PV) into 4 segments. The electrophysiological properties included slow conduction, complex fractionated electrograms, and effective refractory period (ERP).
Results: The slow conduction was more prevalent at PVA (43.2±19.5 vs. 14.7±13.0 %, P=0.001) and PV (61.9±16.4 vs. 9.1±9.0 %, P<0.001) in PAF patients than in PSVT patients during sinus rhythm (SR). Similarly, the area with complex fractionated electrograms was significantly larger at PVA (133.8 [61.6, 233.2] vs. 0.0 [0.0, 41.4] mm2, P=0.011) in PAF patients during SR. The ERP of PVA was longer in PAF patients than in control at the drive length of 600 ms (260 [230, 280] vs. 220 [190, 250] ms, P=0.001) and 400 ms (230 [205, 250] vs. 200 [190, 220] ms, P=0.007). The ERP net difference between the PV and PVA is larger in PAF patients than in control both at 600 ms (40 [20, 70] vs. 10 [10, 30] ms, P<0.001) and (40 [20, 60] vs. 20 [10, 30] ms, P<0.001) at 400 ms pacing, respectively.
Conclusion: PAF patients have the PVA electrical substrate including slow conduction, complex fractionated electrograms and ERP dispersion.
期刊介绍：
HeartRhythm, the official Journal of the Heart Rhythm Society and the Cardiac Electrophysiology Society, is a unique journal for fundamental discovery and clinical applicability.
HeartRhythm integrates the entire cardiac electrophysiology (EP) community from basic and clinical academic researchers, private practitioners, engineers, allied professionals, industry, and trainees, all of whom are vital and interdependent members of our EP community.
The Heart Rhythm Society is the international leader in science, education, and advocacy for cardiac arrhythmia professionals and patients, and the primary information resource on heart rhythm disorders. Its mission is to improve the care of patients by promoting research, education, and optimal health care policies and standards.
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