Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure
Atrial premature depolarizations (APDs) triggering atrial fibrillation (AF) originate from mainly the pulmonary veins (PVs), but, in some cases, atrial ectopic beats (AEBs) triggering AF originate from the right atrium (RA) or the superior vena cava. Accurate identification of the origin of APDs in...
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| Format: | Article |
| Language: | English |
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Wiley
2006-01-01
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| Series: | Journal of Arrhythmia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1880427606800311 |
| _version_ | 1828309023725715456 |
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| author | Kimie Ohkubo, MD Ichiro Watanabe, MD Yasuo Okumura, MD Takeshi Yamada, MD Sonoko Ashino, MD Kenichi Hashimoto, MD Atsushi Shindo, MD Hidezou Sugimura, MD Toshiko Nakai, MD Yukio Ozawa, MD Satoshi Saito, MD |
| author_facet | Kimie Ohkubo, MD Ichiro Watanabe, MD Yasuo Okumura, MD Takeshi Yamada, MD Sonoko Ashino, MD Kenichi Hashimoto, MD Atsushi Shindo, MD Hidezou Sugimura, MD Toshiko Nakai, MD Yukio Ozawa, MD Satoshi Saito, MD |
| author_sort | Kimie Ohkubo, MD |
| collection | DOAJ |
| description | Atrial premature depolarizations (APDs) triggering atrial fibrillation (AF) originate from mainly the pulmonary veins (PVs), but, in some cases, atrial ectopic beats (AEBs) triggering AF originate from the right atrium (RA) or the superior vena cava. Accurate identification of the origin of APDs in the PVs by means of RA and coronary sinus mapping is difficult. Purpose: The aim of this study was to identify the origin of AEBs triggering AF before transseptal catheterization. Electrode catheters were placed in the posteroseptal RA (PSRA), right pulmonary artery (RPA), left pulmonary artery (LPA), and esophagus in 10 patients with paroxysmal AF. We analyzed endocardial electrograms from the PSRA, RPA and LPA, and epicardial electrograms from the esophagus. The origin of the AEBs in the PVs was determined before PV ablation by mapping 4 PVs simultaneously. Four AEBs originated from the left superior PV (LSPV), 2 from the left inferior PV (LIPV), 4 from the right superior PV (RSPV), 2 from the RA or superior vena cava. In AEBs originating from the RA, the PSRA activation was the earliest and it proceeded in a cranial to caudal direction. In AEBs originating from the RUPV, RPA was the earliest. The esophageal activation sequence was in a cranial to caudal direction. In AEBs from the LSPV, LPA was the earliest and the esophageal activation sequence proceeded in a cranial to caudal direction. In AEDs from LIPV, LPA was the earliest, and the esophageal activation sequence was nearly simultaneous. Atrial activation sequences from the PSRA, RPA, LPA, and esophageal catheters can accurately identify the location of the initiating foci of AF before a transseptal procedure. |
| first_indexed | 2024-04-13T15:22:33Z |
| format | Article |
| id | doaj.art-b06a420dfb61420e89b1a5e34e4bc2fb |
| institution | Directory Open Access Journal |
| issn | 1880-4276 |
| language | English |
| last_indexed | 2024-04-13T15:22:33Z |
| publishDate | 2006-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Arrhythmia |
| spelling | doaj.art-b06a420dfb61420e89b1a5e34e4bc2fb2022-12-22T02:41:38ZengWileyJournal of Arrhythmia1880-42762006-01-0122421622410.1016/S1880-4276(06)80031-1Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal ProcedureKimie Ohkubo, MDIchiro Watanabe, MDYasuo Okumura, MDTakeshi Yamada, MDSonoko Ashino, MDKenichi Hashimoto, MDAtsushi Shindo, MDHidezou Sugimura, MDToshiko Nakai, MDYukio Ozawa, MDSatoshi Saito, MDAtrial premature depolarizations (APDs) triggering atrial fibrillation (AF) originate from mainly the pulmonary veins (PVs), but, in some cases, atrial ectopic beats (AEBs) triggering AF originate from the right atrium (RA) or the superior vena cava. Accurate identification of the origin of APDs in the PVs by means of RA and coronary sinus mapping is difficult. Purpose: The aim of this study was to identify the origin of AEBs triggering AF before transseptal catheterization. Electrode catheters were placed in the posteroseptal RA (PSRA), right pulmonary artery (RPA), left pulmonary artery (LPA), and esophagus in 10 patients with paroxysmal AF. We analyzed endocardial electrograms from the PSRA, RPA and LPA, and epicardial electrograms from the esophagus. The origin of the AEBs in the PVs was determined before PV ablation by mapping 4 PVs simultaneously. Four AEBs originated from the left superior PV (LSPV), 2 from the left inferior PV (LIPV), 4 from the right superior PV (RSPV), 2 from the RA or superior vena cava. In AEBs originating from the RA, the PSRA activation was the earliest and it proceeded in a cranial to caudal direction. In AEBs originating from the RUPV, RPA was the earliest. The esophageal activation sequence was in a cranial to caudal direction. In AEBs from the LSPV, LPA was the earliest and the esophageal activation sequence proceeded in a cranial to caudal direction. In AEDs from LIPV, LPA was the earliest, and the esophageal activation sequence was nearly simultaneous. Atrial activation sequences from the PSRA, RPA, LPA, and esophageal catheters can accurately identify the location of the initiating foci of AF before a transseptal procedure.http://www.sciencedirect.com/science/article/pii/S1880427606800311Atrial fibrillationAtrial premature depolarizationsPulmonary vein ablation |
| spellingShingle | Kimie Ohkubo, MD Ichiro Watanabe, MD Yasuo Okumura, MD Takeshi Yamada, MD Sonoko Ashino, MD Kenichi Hashimoto, MD Atsushi Shindo, MD Hidezou Sugimura, MD Toshiko Nakai, MD Yukio Ozawa, MD Satoshi Saito, MD Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure Journal of Arrhythmia Atrial fibrillation Atrial premature depolarizations Pulmonary vein ablation |
| title | Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure |
| title_full | Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure |
| title_fullStr | Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure |
| title_full_unstemmed | Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure |
| title_short | Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure |
| title_sort | identifying the origin of right and left ectopic atrial beats triggering atrial fibrillation before atrial transseptal procedure |
| topic | Atrial fibrillation Atrial premature depolarizations Pulmonary vein ablation |
| url | http://www.sciencedirect.com/science/article/pii/S1880427606800311 |
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