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ID 116343
著者
飛梅, 威 Tokushima University|Saitama Medical University|Kawashima Hospital|Shikoku Medical Center for Children and Adults KAKEN研究者をさがす
Kato, Ritsushi Saitama Medical University
Matsumoto, Kazuhisa Tokushima University
Hara, Motoki Hara Clinic Higashi-Hiroshima
Takamori, Nobuyuki Kawashima Hospital
竹谷, 善雄 Shikoku Medical Center for Children and Adults KAKEN研究者をさがす
Okawa, Keisuke Kagawa Prefectural Central Hospital
Matsumoto, Kazuo Saitama Medical University|HigashiMatsuyama Medical Association Hospital
キーワード
antegrade slow pathway
atrioventricular nodal reentrant tachycardia
extrastimulation
reset
資料タイプ
学術雑誌論文
抄録
Background: Radiofrequency (RF) ablation of typical atrioventricular nodal reentrant tachycardia (tAVNRT) is performed without revealing out the location of antegrade slow pathway (ASp). In this study, we studied a new electrophysiological method of identifying the site of ASp.
Methods: This study included 19 patients. Repeated series of very high-output single extrastimulations (VhoSESts) were delivered at the anatomical slow pathway region during tAVNRT. Tachycardia cycle length (TCL), coupling interval (CI), and return cycle (RC) were measured and the prematurity of VhoSESts [ΔPM (= TCL – CI)] and the prolongation of RCs [ΔPL (= RC – TCL)] were calculated. Pacing sites were classified into two categories: (i) ASp capture sites [DSPC(+) sites], where two different RCs were shown, and ASp non-capture sites [DSPC(-) sites], where only one RC was shown. RF ablation was performed at DSPC(+) sites and/or sites with catheter-induced mechanical trauma (CIMT) to ASp.
Results: DSPC(+) sites were shown in 13 patients (68%). RF ablation was successful in all patients without any degree of atrioventricular block nor recurrence. Total number of RF applications was 1.8 ± 1.1. Minimal distance between successful ablation sites and DSPC(+)/CIMT sites and His bundle (HB) electrogram recording sites was 1.9 ± 0.8 mm and 19.8 ± 6.1 mm, respectively. ΔPL of more than 92.5 ms, ΔPL/TCL of more than 0.286, and ΔPL/ΔPM of more than 1.565 could identify ASp with sensitivity of 100%, 91.1%, and 88.9% and specificity of 92.9%, 97.0%, and 97.6%, respectively.
Conclusions: Sites with ASp capture and CIMT were close to successful ablation sites and could be useful indicators of tAVNRT ablation.
掲載誌名
Journal of Arrhythmia
ISSN
18832148
cat書誌ID
AA12059301
出版者
Japanese Heart Rhythm Society|John Wiley & Sons Australia
37
1
開始ページ
128
終了ページ
139
発行日
2020-12-24
権利情報
This is an open access article under the terms of the Creative Commons Attribution License(https://creativecommons.org/licenses/by/4.0/), which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
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出版社版DOI
出版社版URL
フルテキストファイル
言語
eng
著者版フラグ
出版社版
部局
病院
医学系