Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping
Identifieur interne : 002991 ( Main/Corpus ); précédent : 002990; suivant : 002992Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping
Auteurs : Minglong Chen ; Bing Yang ; Weizhu Ju ; Hongwu Chen ; Chun Chen ; Xiaofeng Hou ; Fengxiang Zhang ; Junyou Cui ; Chuanhuan Zhang ; Qijun Shan ; Jiangang Zou ; Junping Sun ; Yutao Xi ; Jie Cheng ; Kejiang CaoSource :
- Journal of Cardiovascular Electrophysiology [ 1045-3873 ] ; 2010-12.
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Abstract
Right Free Wall Accessory Pathway Ablation. Introduction: The aim of this study was to delineate the electroanatomic substrates of right‐sided free wall (RFW) accessory pathways (APs) that were refractory to conventional catheter ablation utilizing 3‐dimensional (3‐D) mapping. Methods and Results: Eleven patients with RFW APs that failed initial conventional catheter ablation(s) by a mean of 1.9 ± 0.5 attempts were enrolled in the study. Electroanatomic mapping of the right atrium was performed during orthodromic reciprocating tachycardia in 3 patients and right ventricular pacing in 8 patients. The earliest atrial activation site, which represented the atrial insertion of the AP, was separated from the tricuspid annulus by an average of 14.3 ± 3.9 mm, and the local activation time was 27.8 ± 17.0 ms earlier than that of the corresponding annular point. One patient exhibited an AP with wide branching on the atrial side. RF ablation with an irrigated catheter successfully interrupted AP conduction in all patients without complications. Conclusions: RFW APs resistant to conventional catheter ablation might be due to unique anatomic AP features such as more epicardial course at the annulus level with atrial insertion distant from the tricuspid annulus. Electroanatomic mapping is helpful to accurately localize the atrial insertion sites of these APs and facilitates catheter ablation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1317‐1324, December 2010)
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DOI: 10.1111/j.1540-8167.2010.01857.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping</title><author><name sortKey="Chen, Minglong" sort="Chen, Minglong" uniqKey="Chen M" first="Minglong" last="Chen">Minglong Chen</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Yang, Bing" sort="Yang, Bing" uniqKey="Yang B" first="Bing" last="Yang">Bing Yang</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Ju, Weizhu" sort="Ju, Weizhu" uniqKey="Ju W" first="Weizhu" last="Ju">Weizhu Ju</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Chen, Hongwu" sort="Chen, Hongwu" uniqKey="Chen H" first="Hongwu" last="Chen">Hongwu Chen</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Chen, Chun" sort="Chen, Chun" uniqKey="Chen C" first="Chun" last="Chen">Chun Chen</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Hou, Xiaofeng" sort="Hou, Xiaofeng" uniqKey="Hou X" first="Xiaofeng" last="Hou">Xiaofeng Hou</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Zhang, Fengxiang" sort="Zhang, Fengxiang" uniqKey="Zhang F" first="Fengxiang" last="Zhang">Fengxiang Zhang</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Cui, Junyou" sort="Cui, Junyou" uniqKey="Cui J" first="Junyou" last="Cui">Junyou Cui</name><affiliation><mods:affiliation>Department of Cardiology, Jiangyin People's Hospital, Jiangyin, Jiangsu Province, China</mods:affiliation></affiliation></author><author><name sortKey="Zhang, Chuanhuan" sort="Zhang, Chuanhuan" uniqKey="Zhang C" first="Chuanhuan" last="Zhang">Chuanhuan Zhang</name><affiliation><mods:affiliation>Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong Province, China</mods:affiliation></affiliation></author><author><name sortKey="Shan, Qijun" sort="Shan, Qijun" uniqKey="Shan Q" first="Qijun" last="Shan">Qijun Shan</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Zou, Jiangang" sort="Zou, Jiangang" uniqKey="Zou J" first="Jiangang" last="Zou">Jiangang Zou</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Sun, Junping" sort="Sun, Junping" uniqKey="Sun J" first="Junping" last="Sun">Junping Sun</name><affiliation><mods:affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Xi, Yutao" sort="Xi, Yutao" uniqKey="Xi Y" first="Yutao" last="Xi">Yutao Xi</name><affiliation><mods:affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Cheng, Jie" sort="Cheng, Jie" uniqKey="Cheng J" first="Jie" last="Cheng">Jie Cheng</name><affiliation><mods:affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Cao, Kejiang" sort="Cao, Kejiang" uniqKey="Cao K" first="Kejiang" last="Cao">Kejiang Cao</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:624649DBDD0FFBF9C2A5ECD017149C954A6DAFBB</idno><date when="2010" year="2010">2010</date><idno type="doi">10.1111/j.1540-8167.2010.01857.x</idno><idno type="url">https://api.istex.fr/document/624649DBDD0FFBF9C2A5ECD017149C954A6DAFBB/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002991</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping</title><author><name sortKey="Chen, Minglong" sort="Chen, Minglong" uniqKey="Chen M" first="Minglong" last="Chen">Minglong Chen</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Yang, Bing" sort="Yang, Bing" uniqKey="Yang B" first="Bing" last="Yang">Bing Yang</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Ju, Weizhu" sort="Ju, Weizhu" uniqKey="Ju W" first="Weizhu" last="Ju">Weizhu Ju</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Chen, Hongwu" sort="Chen, Hongwu" uniqKey="Chen H" first="Hongwu" last="Chen">Hongwu Chen</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Chen, Chun" sort="Chen, Chun" uniqKey="Chen C" first="Chun" last="Chen">Chun Chen</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Hou, Xiaofeng" sort="Hou, Xiaofeng" uniqKey="Hou X" first="Xiaofeng" last="Hou">Xiaofeng Hou</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Zhang, Fengxiang" sort="Zhang, Fengxiang" uniqKey="Zhang F" first="Fengxiang" last="Zhang">Fengxiang Zhang</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Cui, Junyou" sort="Cui, Junyou" uniqKey="Cui J" first="Junyou" last="Cui">Junyou Cui</name><affiliation><mods:affiliation>Department of Cardiology, Jiangyin People's Hospital, Jiangyin, Jiangsu Province, China</mods:affiliation></affiliation></author><author><name sortKey="Zhang, Chuanhuan" sort="Zhang, Chuanhuan" uniqKey="Zhang C" first="Chuanhuan" last="Zhang">Chuanhuan Zhang</name><affiliation><mods:affiliation>Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong Province, China</mods:affiliation></affiliation></author><author><name sortKey="Shan, Qijun" sort="Shan, Qijun" uniqKey="Shan Q" first="Qijun" last="Shan">Qijun Shan</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Zou, Jiangang" sort="Zou, Jiangang" uniqKey="Zou J" first="Jiangang" last="Zou">Jiangang Zou</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author><author><name sortKey="Sun, Junping" sort="Sun, Junping" uniqKey="Sun J" first="Junping" last="Sun">Junping Sun</name><affiliation><mods:affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Xi, Yutao" sort="Xi, Yutao" uniqKey="Xi Y" first="Yutao" last="Xi">Yutao Xi</name><affiliation><mods:affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Cheng, Jie" sort="Cheng, Jie" uniqKey="Cheng J" first="Jie" last="Cheng">Jie Cheng</name><affiliation><mods:affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Cao, Kejiang" sort="Cao, Kejiang" uniqKey="Cao K" first="Kejiang" last="Cao">Kejiang Cao</name><affiliation><mods:affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="ISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><imprint><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2010-12">2010-12</date><biblScope unit="volume">21</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1317">1317</biblScope><biblScope unit="page" to="1324">1324</biblScope></imprint><idno type="ISSN">1045-3873</idno></series><idno type="istex">624649DBDD0FFBF9C2A5ECD017149C954A6DAFBB</idno><idno type="DOI">10.1111/j.1540-8167.2010.01857.x</idno><idno type="ArticleID">JCE1857</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1045-3873</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Wolff‐Parkinson‐White syndrome</term><term>accessory pathway</term><term>catheter ablation</term><term>electroanatomic mapping</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Right Free Wall Accessory Pathway Ablation. Introduction: The aim of this study was to delineate the electroanatomic substrates of right‐sided free wall (RFW) accessory pathways (APs) that were refractory to conventional catheter ablation utilizing 3‐dimensional (3‐D) mapping. Methods and Results: Eleven patients with RFW APs that failed initial conventional catheter ablation(s) by a mean of 1.9 ± 0.5 attempts were enrolled in the study. Electroanatomic mapping of the right atrium was performed during orthodromic reciprocating tachycardia in 3 patients and right ventricular pacing in 8 patients. The earliest atrial activation site, which represented the atrial insertion of the AP, was separated from the tricuspid annulus by an average of 14.3 ± 3.9 mm, and the local activation time was 27.8 ± 17.0 ms earlier than that of the corresponding annular point. One patient exhibited an AP with wide branching on the atrial side. RF ablation with an irrigated catheter successfully interrupted AP conduction in all patients without complications. Conclusions: RFW APs resistant to conventional catheter ablation might be due to unique anatomic AP features such as more epicardial course at the annulus level with atrial insertion distant from the tricuspid annulus. Electroanatomic mapping is helpful to accurately localize the atrial insertion sites of these APs and facilitates catheter ablation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1317‐1324, December 2010)</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>MINGLONG CHEN M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>BING YANG M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>WEIZHU JU M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>HONGWU CHEN M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>CHUN CHEN M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>XIAOFENG HOU M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>FENGXIANG ZHANG M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>JUNYOU CUI M.D.</name><affiliations><json:string>Department of Cardiology, Jiangyin People's Hospital, Jiangyin, Jiangsu Province, China</json:string></affiliations></json:item><json:item><name>CHUANHUAN ZHANG M.D.</name><affiliations><json:string>Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong Province, China</json:string></affiliations></json:item><json:item><name>QIJUN SHAN M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>JIANGANG ZOU M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item><json:item><name>JUNPING SUN M.D.</name><affiliations><json:string>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>YUTAO XI M.D.</name><affiliations><json:string>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>JIE CHENG M.D., Ph.D., F.A.C.C., F.H.R.S.</name><affiliations><json:string>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>KEJIANG CAO M.D.</name><affiliations><json:string>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>electroanatomic mapping</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>catheter ablation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>accessory pathway</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Wolff‐Parkinson‐White syndrome</value></json:item></subject><articleId><json:string>JCE1857</json:string></articleId><language><json:string>eng</json:string></language><abstract>Right Free Wall Accessory Pathway Ablation. Introduction: The aim of this study was to delineate the electroanatomic substrates of right‐sided free wall (RFW) accessory pathways (APs) that were refractory to conventional catheter ablation utilizing 3‐dimensional (3‐D) mapping. Methods and Results: Eleven patients with RFW APs that failed initial conventional catheter ablation(s) by a mean of 1.9 ± 0.5 attempts were enrolled in the study. Electroanatomic mapping of the right atrium was performed during orthodromic reciprocating tachycardia in 3 patients and right ventricular pacing in 8 patients. The earliest atrial activation site, which represented the atrial insertion of the AP, was separated from the tricuspid annulus by an average of 14.3 ± 3.9 mm, and the local activation time was 27.8 ± 17.0 ms earlier than that of the corresponding annular point. One patient exhibited an AP with wide branching on the atrial side. RF ablation with an irrigated catheter successfully interrupted AP conduction in all patients without complications. Conclusions: RFW APs resistant to conventional catheter ablation might be due to unique anatomic AP features such as more epicardial course at the annulus level with atrial insertion distant from the tricuspid annulus. Electroanatomic mapping is helpful to accurately localize the atrial insertion sites of these APs and facilitates catheter ablation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1317‐1324, December 2010)</abstract><qualityIndicators><score>7.214</score><pdfVersion>1.4</pdfVersion><pdfPageSize>594 x 783 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1471</abstractCharCount><pdfWordCount>4110</pdfWordCount><pdfCharCount>26194</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>217</abstractWordCount></qualityIndicators><title>Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic 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China</affiliation></author><author><persName><forename type="first">WEIZHU</forename><surname>JU</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author><author><persName><forename type="first">HONGWU</forename><surname>CHEN</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author><author><persName><forename type="first">CHUN</forename><surname>CHEN</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author><author><persName><forename type="first">XIAOFENG</forename><surname>HOU</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author><author><persName><forename type="first">FENGXIANG</forename><surname>ZHANG</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author><author><persName><forename type="first">JUNYOU</forename><surname>CUI</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, Jiangyin People's Hospital, Jiangyin, Jiangsu Province, China</affiliation></author><author><persName><forename type="first">CHUANHUAN</forename><surname>ZHANG</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong Province, China</affiliation></author><author><persName><forename type="first">QIJUN</forename><surname>SHAN</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author><author><persName><forename type="first">JIANGANG</forename><surname>ZOU</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author><author><persName><forename type="first">JUNPING</forename><surname>SUN</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">YUTAO</forename><surname>XI</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">JIE</forename><surname>CHENG</surname></persName><roleName type="degree">M.D., Ph.D., F.A.C.C., F.H.R.S.</roleName><affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">KEJIANG</forename><surname>CAO</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation></author></analytic><monogr><title level="j">Journal of Cardiovascular Electrophysiology</title><idno type="pISSN">1045-3873</idno><idno type="eISSN">1540-8167</idno><idno type="DOI">10.1111/(ISSN)1540-8167</idno><imprint><publisher>Blackwell Publishing Inc</publisher><pubPlace>Malden, USA</pubPlace><date type="published" when="2010-12"></date><biblScope unit="volume">21</biblScope><biblScope unit="issue">12</biblScope><biblScope unit="page" from="1317">1317</biblScope><biblScope unit="page" to="1324">1324</biblScope></imprint></monogr><idno type="istex">624649DBDD0FFBF9C2A5ECD017149C954A6DAFBB</idno><idno type="DOI">10.1111/j.1540-8167.2010.01857.x</idno><idno type="ArticleID">JCE1857</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2010</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Right Free Wall Accessory Pathway Ablation. Introduction: The aim of this study was to delineate the electroanatomic substrates of right‐sided free wall (RFW) accessory pathways (APs) that were refractory to conventional catheter ablation utilizing 3‐dimensional (3‐D) mapping. Methods and Results: Eleven patients with RFW APs that failed initial conventional catheter ablation(s) by a mean of 1.9 ± 0.5 attempts were enrolled in the study. Electroanatomic mapping of the right atrium was performed during orthodromic reciprocating tachycardia in 3 patients and right ventricular pacing in 8 patients. The earliest atrial activation site, which represented the atrial insertion of the AP, was separated from the tricuspid annulus by an average of 14.3 ± 3.9 mm, and the local activation time was 27.8 ± 17.0 ms earlier than that of the corresponding annular point. One patient exhibited an AP with wide branching on the atrial side. RF ablation with an irrigated catheter successfully interrupted AP conduction in all patients without complications. Conclusions: RFW APs resistant to conventional catheter ablation might be due to unique anatomic AP features such as more epicardial course at the annulus level with atrial insertion distant from the tricuspid annulus. Electroanatomic mapping is helpful to accurately localize the atrial insertion sites of these APs and facilitates catheter ablation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1317‐1324, December 2010)</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>electroanatomic mapping</term></item><item><term>catheter ablation</term></item><item><term>accessory pathway</term></item><item><term>Wolff‐Parkinson‐White syndrome</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-12">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/624649DBDD0FFBF9C2A5ECD017149C954A6DAFBB/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Inc</publisherName><publisherLoc>Malden, USA</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8167</doi><issn type="print">1045-3873</issn><issn type="electronic">1540-8167</issn><idGroup><id type="product" value="JCE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY">Journal of Cardiovascular Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="12112"><doi origin="wiley">10.1111/jce.2010.21.issue-12</doi><numberingGroup><numbering type="journalVolume" number="21">21</numbering><numbering type="journalIssue" number="12">12</numbering></numberingGroup><coverDate startDate="2010-12">December 2010</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="1" status="forIssue"><doi origin="wiley">10.1111/j.1540-8167.2010.01857.x</doi><idGroup><id type="unit" value="JCE1857"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="tocHeading1">ORIGINAL ARTICLES</title><title type="tocHeading2"><i>Clinical</i></title></titleGroup><copyright>© 2010 Wiley Periodicals, Inc.</copyright><eventGroup><event type="firstOnline" date="2010-12-06"></event><event type="publishedOnlineAcceptedOrEarlyUnpaginated" date="2010-07-23"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.27 mode:FullText" date="2010-12-06"></event><event type="publishedOnlineFinalForm" date="2010-12-06"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-29"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-23"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="1317">1317</numbering><numbering type="pageLast" number="1324">1324</numbering></numberingGroup><correspondenceTo>Address for correspondence: Kejiang Cao, M.D., Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Number 300, Guangzhou Road, Nanjing 210029, China. Fax: 0086‐25‐8371‐7168; E‐mail: <email>kjcao@njmu.edu.cn</email> or Jie Cheng, M.D., P<sc>h</sc>.D., Texas Heart Institute/St. Luke's Episcopal Hospital, 6770 Bertner Street, MC 2‐255, Houston, TX 77030, USA. Fax: 832‐355‐8880; E‐mail: <email>jcheng@heart.thi.tmc.edu</email></correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:JCE.JCE1857.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Manuscript received 30 March 2010; Revised manuscript received 10 May 2010; Accepted for publication 21 May 2010.</unparsedEditorialHistory><countGroup><count type="figureTotal" number="6"></count><count type="tableTotal" number="1"></count><count type="formulaTotal" number="0"></count><count type="referenceTotal" number="23"></count><count type="linksCrossRef" number="48"></count></countGroup><titleGroup><title type="main">Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>MINGLONG</givenNames><familyName>CHEN</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>BING</givenNames><familyName>YANG</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>WEIZHU</givenNames><familyName>JU</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>HONGWU</givenNames><familyName>CHEN</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a1"><personName><givenNames>CHUN</givenNames><familyName>CHEN</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>XIAOFENG</givenNames><familyName>HOU</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr7" affiliationRef="#a1"><personName><givenNames>FENGXIANG</givenNames><familyName>ZHANG</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr8" affiliationRef="#a2"><personName><givenNames>JUNYOU</givenNames><familyName>CUI</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr9" affiliationRef="#a3"><personName><givenNames>CHUANHUAN</givenNames><familyName>ZHANG</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr10" affiliationRef="#a1"><personName><givenNames>QIJUN</givenNames><familyName>SHAN</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr11" affiliationRef="#a1"><personName><givenNames>JIANGANG</givenNames><familyName>ZOU</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr12" affiliationRef="#a4"><personName><givenNames>JUNPING</givenNames><familyName>SUN</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr13" affiliationRef="#a4"><personName><givenNames>YUTAO</givenNames><familyName>XI</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr14" affiliationRef="#a4"><personName><givenNames>JIE</givenNames><familyName>CHENG</familyName><degrees>M.D., Ph.D., F.A.C.C., F.H.R.S.</degrees></personName></creator><creator creatorRole="author" xml:id="cr15" affiliationRef="#a1"><personName><givenNames>KEJIANG</givenNames><familyName>CAO</familyName><degrees>M.D.</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="CN"><unparsedAffiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="CN"><unparsedAffiliation>Department of Cardiology, Jiangyin People's Hospital, Jiangyin, Jiangsu Province, China</unparsedAffiliation></affiliation><affiliation xml:id="a3" countryCode="CN"><unparsedAffiliation>Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong Province, China</unparsedAffiliation></affiliation><affiliation xml:id="a4" countryCode="US"><unparsedAffiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1"><i>electroanatomic mapping</i></keyword><keyword xml:id="k2"><i>catheter ablation</i></keyword><keyword xml:id="k3"><i>accessory pathway</i></keyword><keyword xml:id="k4"><i>Wolff‐Parkinson‐White syndrome</i></keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p> <b>Right Free Wall Accessory Pathway Ablation</b>. <i>Introduction:</i> The aim of this study was to delineate the electroanatomic substrates of right‐sided free wall (RFW) accessory pathways (APs) that were refractory to conventional catheter ablation utilizing 3‐dimensional (3‐D) mapping.</p><p> <b><i>Methods and Results:</i></b> Eleven patients with RFW APs that failed initial conventional catheter ablation(s) by a mean of 1.9 ± 0.5 attempts were enrolled in the study. Electroanatomic mapping of the right atrium was performed during orthodromic reciprocating tachycardia in 3 patients and right ventricular pacing in 8 patients. The earliest atrial activation site, which represented the atrial insertion of the AP, was separated from the tricuspid annulus by an average of 14.3 ± 3.9 mm, and the local activation time was 27.8 ± 17.0 ms earlier than that of the corresponding annular point. One patient exhibited an AP with wide branching on the atrial side. RF ablation with an irrigated catheter successfully interrupted AP conduction in all patients without complications.</p><p> <b><i>Conclusions:</i></b> RFW APs resistant to conventional catheter ablation might be due to unique anatomic AP features such as more epicardial course at the annulus level with atrial insertion distant from the tricuspid annulus. Electroanatomic mapping is helpful to accurately localize the atrial insertion sites of these APs and facilitates catheter ablation. <i>(J Cardiovasc Electrophysiol, Vol. 21, pp. 1317‐1324, December 2010)</i></p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="n-fnt-1"><p>Drs. Chen and Yang contributed equally to this work.</p></note><note xml:id="n-fnt-2"><p>No disclosures.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping</title></titleInfo><name type="personal"><namePart type="given">MINGLONG</namePart><namePart type="family">CHEN</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">BING</namePart><namePart type="family">YANG</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">WEIZHU</namePart><namePart type="family">JU</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">HONGWU</namePart><namePart type="family">CHEN</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">CHUN</namePart><namePart type="family">CHEN</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">XIAOFENG</namePart><namePart type="family">HOU</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">FENGXIANG</namePart><namePart type="family">ZHANG</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JUNYOU</namePart><namePart type="family">CUI</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, Jiangyin People's Hospital, Jiangyin, Jiangsu Province, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">CHUANHUAN</namePart><namePart type="family">ZHANG</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong Province, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">QIJUN</namePart><namePart type="family">SHAN</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JIANGANG</namePart><namePart type="family">ZOU</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JUNPING</namePart><namePart type="family">SUN</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">YUTAO</namePart><namePart type="family">XI</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">JIE</namePart><namePart type="family">CHENG</namePart><namePart type="termsOfAddress">M.D., Ph.D., F.A.C.C., F.H.R.S.</namePart><affiliation>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">KEJIANG</namePart><namePart type="family">CAO</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Inc</publisher><place><placeTerm type="text">Malden, USA</placeTerm></place><dateIssued encoding="w3cdtf">2010-12</dateIssued><edition>Manuscript received 30 March 2010; Revised manuscript received 10 May 2010; Accepted for publication 21 May 2010.</edition><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">6</extent><extent unit="tables">1</extent><extent unit="references">23</extent></physicalDescription><abstract lang="en">Right Free Wall Accessory Pathway Ablation. Introduction: The aim of this study was to delineate the electroanatomic substrates of right‐sided free wall (RFW) accessory pathways (APs) that were refractory to conventional catheter ablation utilizing 3‐dimensional (3‐D) mapping. Methods and Results: Eleven patients with RFW APs that failed initial conventional catheter ablation(s) by a mean of 1.9 ± 0.5 attempts were enrolled in the study. Electroanatomic mapping of the right atrium was performed during orthodromic reciprocating tachycardia in 3 patients and right ventricular pacing in 8 patients. The earliest atrial activation site, which represented the atrial insertion of the AP, was separated from the tricuspid annulus by an average of 14.3 ± 3.9 mm, and the local activation time was 27.8 ± 17.0 ms earlier than that of the corresponding annular point. One patient exhibited an AP with wide branching on the atrial side. RF ablation with an irrigated catheter successfully interrupted AP conduction in all patients without complications. Conclusions: RFW APs resistant to conventional catheter ablation might be due to unique anatomic AP features such as more epicardial course at the annulus level with atrial insertion distant from the tricuspid annulus. Electroanatomic mapping is helpful to accurately localize the atrial insertion sites of these APs and facilitates catheter ablation. (J Cardiovasc Electrophysiol, Vol. 21, pp. 1317‐1324, December 2010)</abstract><subject lang="en"><genre>Keywords</genre><topic>electroanatomic mapping</topic><topic>catheter ablation</topic><topic>accessory pathway</topic><topic>Wolff‐Parkinson‐White syndrome</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Cardiovascular Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">1045-3873</identifier><identifier type="eISSN">1540-8167</identifier><identifier type="DOI">10.1111/(ISSN)1540-8167</identifier><identifier type="PublisherID">JCE</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>21</number></detail><detail type="issue"><caption>no.</caption><number>12</number></detail><extent unit="pages"><start>1317</start><end>1324</end><total>8</total></extent></part></relatedItem><identifier type="istex">624649DBDD0FFBF9C2A5ECD017149C954A6DAFBB</identifier><identifier type="DOI">10.1111/j.1540-8167.2010.01857.x</identifier><identifier type="ArticleID">JCE1857</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2010 Wiley Periodicals, Inc.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Inc</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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