Valvular Atrial Fibrillation: Electrophysiological study and etopic origin
- VernacularTitle:风湿性心脏病心房颤动起源的心脏电生理研究
- Author:
Hao LIU
;
Jihong GUO
- Publication Type:Journal Article
- Keywords:
Rheumatic heart disease;
Atrial fibrillation;
Pulmonary veins;
Electrophysiologic techniques, cardiac
- From:
Chinese Journal of Interventional Cardiology
1996;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective Mapping the sites of earliest activation in AF patients with rheumatic heart disease. Finding out the ratio of AF originate from the pulmonary veins. Methods There were 9 patients with valvular atrial fibrillation (1 male, 8 females age (42?13) years, histories of rheumatic heart disease (11?9) years, and mitral valve area 1.01?0.02 cm2) involved in the research. 3 patients had organized thrombus in left atrial appendage. 6 patients with persistent AF received anticoagulation therapy (warfarin 2 or 3 weeks) and drug cardioversion (amiodarone 400 mg, three times per day, for 7 days) before procedures, while other 3 patients with paroxysmal AF received neither anticoagulation therapy nor drug cardioversion. All patients received percutaneous balloon mitral valvotomy (PBMV). After finished PBMV, four multipolar electrode catheters were placed in the high right atrium (HRA), coronary sinus (CS), left atrium (LA) and pulmonary veins (PVs). S1S2 and S1S2S3 programmed stimuli were delivered in HRA, CS, LA and PVs respectively. For the patients who failed to induce AF, burst stimuli were used. Results 11 AF generating sites, which induced by S1S2 and S1S2S3 programmed stimuli, could be confirmed by identification of the earliest regions of atrial activation for the first AF cycle. However, 1 AF obtained by 260 ms RR interval burst stimuli, affirmed by shortest activation cycle length. All confirmed 12 AF original sites were original as following: RA (n=4), LA (n=1), CS (n=2); PVs (n=5). Among the 5 PVs original sites, 3 was from left superior pulmonary vein, while the other 2 were from right superior pulmonary vein and left inferior pulmonary respectively. Conclusion PVs could be the ectopic origin of valvular AF.
