Electrophysiologic Characteristics of Post-cardiac-surgical Atrial Tachycardia under Ultra-high Density and High-resolution Mapping
- VernacularTitle:高密度高分辨标测下外科术后房性心动过速的电生理特征
- Author:
Jie LI
1
;
Feng-jiao YAN
1
;
Na TANG
2
;
Chen SU
1
;
Jing-zhou JIANG
1
;
Meng-hui LIU
1
;
Jian-gui HE
1
;
Li-chun WANG
1
Author Information
1. Department of Cardiology， The First Affiliated Hospital of Sun Yat-sen University， Guangzhou 510080 ，China
2. Department of Cardiology， The Affiliated Hospital of Xiangnan University， Chenzhou 423000， China
- Publication Type:Journal Article
- Keywords:
post-cardiac-surgical atrial tachycardia;
ultrahigh-density mapping;
mini-electrodes;
ablation
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2021;42(1):95-101
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the electrophysiologic characteristics of post-cardiac-surgical atrial tachycardia （AT） under ultra-high density and high-resolution mapping. MethodsConsecutive cases with post-cardiac-surgical AT and taking mapping using Orion basketball mini-electrode and Rhythmia mapping system were collected and analyzed in the first affiliated hospital of Sun Yat-sen University from march 2016 to december 2019. ResultsTotally 26 ATs were recorded in the 21 patients with a mean mapping time （19.1±7.1）min. Among them， 20 （76.9%） ATs located in right atrium， 5 （19.2%） in left atrium， and one was a bi-atrial macro-reentrant AT. According the difference of tachycardia mechanism， 24 （92.3%） were macro-reentrant ATs， one was micro-reentrant， and the other was local activation. In the macro-reentrant ATs， 7 cases showed a dual-loop reentrant circuit configurated “figure-of-eight”， one was a bi-atrial macro-reentry with a transmural conduction from left side to right side of atrial septum. During ablation， 4 patients in the 7 cases with “figure-of-eight” dual-loop reentries turned into a single-loop reentry. During follow-up with an average of 16 （4， 36） months， 2 cases recurred， and one was because of no prophylactic ablation on the tricuspid isthmus. ConclusionsPost-cardiac-surgical atrial tachycardia mainly manifests as complicated macro-reentrant AT. Some show a dual-loop reentry and sometimes a bi-atrial macro-reentry. During ablation， some prophylactic ablation according to the substrate is necessary.
