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学科主题临床医学
Focal atrial tachycardia arising from the right atrial appendage: electrophysiologic and electrocardiographic characteristics and catheter ablation
Zhang, T.; Li, X. -B.; Wang, Y. -L.; Yin, J. -X.; Zhang, P.; Zhang, H. -C.; Xu, Y.; Guo, J. -H.
刊名INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
2009-03-01
DOI10.1111/j.1742-1241.2007.01489.x
63期:3页:417-424
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Medicine, General & Internal ; Pharmacology & Pharmacy
研究领域[WOS]General & Internal Medicine ; Pharmacology & Pharmacy
关键词[WOS]RADIOFREQUENCY ABLATION ; MITRAL ANNULUS ; ORIGIN ; PREDICT ; SITE
英文摘要

Focal atrial tachycardia (AT) arising from the crista terminalis, pulmonary veins, para-Hisian region, tricuspid annulus and coronary sinus ostium regions are well described. Less information exists regarding AT arising from the right atrial appendage (RAA).

The study was done to characterise the electrocardiographic and electrophysiologic features and radiofrequency ablation (RFA) of focal AT arising from the RAA.

Six patients of a consecutive series of 250 patients undergoing RFA for focal AT are reported. Mapping was performed during tachycardia or frequent atrial ectopy to identify the earliest activation in the atria. Atrial appendage angiography was performed to identify the origin in the RAA after RFA.

All the six (2.4%) patients (four women; mean age 26 +/- 11 years) had tachycardia originating from RAA. The tachycardia demonstrated a characteristic P-wave morphology and endocardial activation pattern. P-wave morphology was upright in I, II, III and aVF, inverted in aVR, inverted or isoelectric in aVL. Lead V(1) showed a negative component and lead V(4)-V(6) showed an upright component in all the patients. The earliest endocardial activity occurred at the high right atria in all the patients. The earliest endocardial activation at the successful RFA site occurred 48 +/- 18 ms before the onset of the P wave. RFA was highly successful in all the six patients. Long-term success was achieved in six of the six patients over a mean follow-up of 24 +/- 5 months.

The RAA is an uncommon site of origin for focal AT 2.4%. There is consistent P-wave morphology and endocardial activation associated with this type of AT. Using mapping targeted to anatomic structures achieved a high success rate for ablation. Irrigated-tip catheter may be helpful for patients who had a recurrence.

语种英语
WOS记录号WOS:000262953500012
Citation statistics
Cited Times:7[WOS]   [WOS Record]     [Related Records in WOS]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/51133
Collection北京大学第二临床医学院_心血管内科
作者单位Peking Univ, Peoples Hosp, Dept Cardiol, Beijing 100044, Peoples R China
Recommended Citation
GB/T 7714
Zhang, T.,Li, X. -B.,Wang, Y. -L.,et al. Focal atrial tachycardia arising from the right atrial appendage: electrophysiologic and electrocardiographic characteristics and catheter ablation[J]. INTERNATIONAL JOURNAL OF CLINICAL PRACTICE,2009,63(3):417-424.
APA Zhang, T..,Li, X. -B..,Wang, Y. -L..,Yin, J. -X..,Zhang, P..,...&Guo, J. -H..(2009).Focal atrial tachycardia arising from the right atrial appendage: electrophysiologic and electrocardiographic characteristics and catheter ablation.INTERNATIONAL JOURNAL OF CLINICAL PRACTICE,63(3),417-424.
MLA Zhang, T.,et al."Focal atrial tachycardia arising from the right atrial appendage: electrophysiologic and electrocardiographic characteristics and catheter ablation".INTERNATIONAL JOURNAL OF CLINICAL PRACTICE 63.3(2009):417-424.
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