Association between dissociated firing in isolated pulmonary veins and the initiation and maintenance of atrial fibrillation
BACKGROUND: Whether dissociated firing (DiFi) in isolated pulmonary veins (PVs) implies arrhythmogenicity of the particular PVand, therefore, a better outcome of PV isolation (PVI) for paroxysmal atrial fibrillation (PAF) is debated. METHODS: Thirty-one patients undergoing their first PVI for PAF we...
Elmentve itt :
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| Dokumentumtípus: | Cikk |
| Megjelent: |
2016
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| Sorozat: | JOURNAL OF INTERVENTIONAL CARDIAC ELECTROPHYSIOLOGY
45 No. 1 |
| doi: | 10.1007/s10840-015-0070-9 |
| mtmt: | 3365587 |
| Online Access: | http://publicatio.bibl.u-szeged.hu/16116 |
| Tartalmi kivonat: | BACKGROUND: Whether dissociated firing (DiFi) in isolated pulmonary veins (PVs) implies arrhythmogenicity of the particular PVand, therefore, a better outcome of PV isolation (PVI) for paroxysmal atrial fibrillation (PAF) is debated. METHODS: Thirty-one patients undergoing their first PVI for PAF were studied. Isoproterenol was infused for induction, and the triggering PV was identified. During sustained PAF, sequential recordings were made with a decapolar circular mapping catheter from each PV. The dominant frequency (DF) was determined using fast Fourier transformation. Spontaneous DiFi was monitored for 30 min after PVI. RESULTS: PAF was triggered by the PVs in all patients. Fourteen (45 %) patients had DiFi after PVI in at least one PV. It was recorded most commonly from the left upper (84 %) and lower (67 %), less commonly from the right upper (31 %) PV. Out of the 23 PVs with DiFi, 13 (57 %) showed sporadic ectopic beats while 10 (44 %) had sustained ectopic rhythm or isolated tachycardia. There was no difference in size between PVs with or without DiFi (5.9+/-1.2 vs. 5.6+/-1.0 cm ostial perimeter, p=0.40). Triggering PVs more commonly showed any DiFi, compared to nontriggering PVs (68 vs. 27 %, p=0.003) and more commonly had sustained DiFi (53 vs. 0 %, p<0.001). During PAF PVs with any DiFi showed faster maximal DF compared to PVs without DiFi (7.1+/-1.3 vs. 5.9+/-1.1 Hz, p=0.001). Higher maximal DF was recorded in PVs with sustained versus sporadic DiFi versus PVs without DiFi (7.5 +/-0.9 vs. 6.8+/-1.6 vs. 5.9+/-1.1 Hz, respectively, p=0.002). Patients with DiFi after PVI had a longer mean time to recurrent PAF compared to those without DiFi (52 vs. 32 months, p=0.048). CONCLUSIONS: Dissociated firing in isolated PVs is associated with their role in the initiation and maintenance of PAF. |
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| Terjedelem/Fizikai jellemzők: | 29-35 |
| ISSN: | 1383-875X |