Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping
Identifieur interne : 000554 ( Main/Exploration ); précédent : 000553; suivant : 000555Right‐Sided Free Wall Accessory Pathway Refractory to Conventional Catheter Ablation: Lessons From 3‐Dimensional Electroanatomic Mapping
Auteurs : Minglong Chen [République populaire de Chine] ; Bing Yang [République populaire de Chine] ; Weizhu Ju [République populaire de Chine] ; Hongwu Chen [République populaire de Chine] ; Chun Chen [République populaire de Chine] ; Xiaofeng Hou [République populaire de Chine] ; Fengxiang Zhang [République populaire de Chine] ; Junyou Cui [République populaire de Chine] ; Chuanhuan Zhang [République populaire de Chine] ; Qijun Shan [République populaire de Chine] ; Jiangang Zou [République populaire de Chine] ; Junping Sun [États-Unis] ; Yutao Xi [États-Unis] ; Jie Cheng [États-Unis] ; Kejiang Cao [République populaire de Chine]Source :
- 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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first="Minglong" last="Chen">Minglong Chen</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing</wicri:regionArea><wicri:noRegion>Nanjing</wicri:noRegion></affiliation></author><author><name sortKey="Yang, Bing" sort="Yang, Bing" uniqKey="Yang B" first="Bing" last="Yang">Bing Yang</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing</wicri:regionArea><wicri:noRegion>Nanjing</wicri:noRegion></affiliation></author><author><name sortKey="Ju, Weizhu" sort="Ju, Weizhu" uniqKey="Ju W" first="Weizhu" last="Ju">Weizhu Ju</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, the First Affiliated 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X" first="Xiaofeng" last="Hou">Xiaofeng Hou</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing</wicri:regionArea><wicri:noRegion>Nanjing</wicri:noRegion></affiliation></author><author><name sortKey="Zhang, Fengxiang" sort="Zhang, Fengxiang" uniqKey="Zhang F" first="Fengxiang" last="Zhang">Fengxiang Zhang</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing</wicri:regionArea><wicri:noRegion>Nanjing</wicri:noRegion></affiliation></author><author><name sortKey="Cui, Junyou" sort="Cui, Junyou" uniqKey="Cui J" first="Junyou" last="Cui">Junyou Cui</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, Jiangyin People's Hospital, Jiangyin, Jiangsu Province</wicri:regionArea><wicri:noRegion>Jiangsu Province</wicri:noRegion></affiliation></author><author><name sortKey="Zhang, Chuanhuan" sort="Zhang, Chuanhuan" uniqKey="Zhang C" first="Chuanhuan" last="Zhang">Chuanhuan Zhang</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong Province</wicri:regionArea><wicri:noRegion>Shandong Province</wicri:noRegion></affiliation></author><author><name sortKey="Shan, Qijun" sort="Shan, Qijun" uniqKey="Shan Q" first="Qijun" last="Shan">Qijun Shan</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing</wicri:regionArea><wicri:noRegion>Nanjing</wicri:noRegion></affiliation></author><author><name sortKey="Zou, Jiangang" sort="Zou, Jiangang" uniqKey="Zou J" first="Jiangang" last="Zou">Jiangang Zou</name><affiliation wicri:level="1"><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing</wicri:regionArea><wicri:noRegion>Nanjing</wicri:noRegion></affiliation></author><author><name sortKey="Sun, Junping" sort="Sun, Junping" uniqKey="Sun J" first="Junping" last="Sun">Junping Sun</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Texas Heart Institute./St. Luke's Episcopal Hospital, Houston, Texas</wicri:regionArea><placeName><region type="state">Texas</region></placeName></affiliation></author><author><name sortKey="Xi, Yutao" sort="Xi, Yutao" uniqKey="Xi Y" first="Yutao" last="Xi">Yutao Xi</name><affiliation wicri:level="2"><country xml:lang="fr">États-Unis</country><wicri:regionArea>Texas Heart Institute./St. Luke's Episcopal 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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><affiliations><list><country><li>République populaire de Chine</li><li>États-Unis</li></country><region><li>Texas</li></region></list><tree><country name="République populaire de Chine"><noRegion><name sortKey="Chen, Minglong" sort="Chen, Minglong" uniqKey="Chen M" first="Minglong" last="Chen">Minglong Chen</name></noRegion><name sortKey="Cao, Kejiang" sort="Cao, Kejiang" uniqKey="Cao K" first="Kejiang" last="Cao">Kejiang Cao</name><name sortKey="Chen, Chun" sort="Chen, Chun" uniqKey="Chen C" first="Chun" last="Chen">Chun Chen</name><name sortKey="Chen, Hongwu" sort="Chen, Hongwu" uniqKey="Chen H" first="Hongwu" last="Chen">Hongwu Chen</name><name sortKey="Cui, Junyou" sort="Cui, Junyou" uniqKey="Cui J" first="Junyou" last="Cui">Junyou Cui</name><name sortKey="Hou, Xiaofeng" sort="Hou, Xiaofeng" uniqKey="Hou X" first="Xiaofeng" last="Hou">Xiaofeng Hou</name><name sortKey="Ju, Weizhu" sort="Ju, Weizhu" uniqKey="Ju W" first="Weizhu" last="Ju">Weizhu Ju</name><name sortKey="Shan, Qijun" sort="Shan, Qijun" uniqKey="Shan Q" first="Qijun" last="Shan">Qijun Shan</name><name sortKey="Yang, Bing" sort="Yang, Bing" uniqKey="Yang B" first="Bing" last="Yang">Bing Yang</name><name sortKey="Zhang, Chuanhuan" sort="Zhang, Chuanhuan" uniqKey="Zhang C" first="Chuanhuan" last="Zhang">Chuanhuan Zhang</name><name sortKey="Zhang, Fengxiang" sort="Zhang, Fengxiang" uniqKey="Zhang F" first="Fengxiang" last="Zhang">Fengxiang Zhang</name><name sortKey="Zou, Jiangang" sort="Zou, Jiangang" uniqKey="Zou J" first="Jiangang" last="Zou">Jiangang Zou</name></country><country name="États-Unis"><region name="Texas"><name sortKey="Sun, Junping" sort="Sun, Junping" uniqKey="Sun J" first="Junping" last="Sun">Junping Sun</name></region><name sortKey="Cheng, Jie" sort="Cheng, Jie" uniqKey="Cheng J" first="Jie" last="Cheng">Jie Cheng</name><name sortKey="Xi, Yutao" sort="Xi, Yutao" uniqKey="Xi Y" first="Yutao" last="Xi">Yutao Xi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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