Jaïs P, Shah D C, Haïssaguerre M, Hocini M, Peng J T, Takahashi A, Garrigue S, Le Métayer P, Clémenty J
Hôpital Cardiologique du Haut-Lévéque, Bordeaux-Pessac, France.
Circulation. 2000 Jun 27;101(25):2928-34. doi: 10.1161/01.cir.101.25.2928.
Typical right atrial isthmus-dependent flutters have been described in detail, but very little is known about left atrial (LA) flutters.
We performed conventional and 3D mapping of the LA for 22 patients with atypical flutters. Complete maps in 17 patients demonstrated macroreentrant circuits (n=15) with 1 to 3 loops rotating around the mitral annulus, the pulmonary veins, and a zone of block or a silent area. In 2 patients, a small reentry circuit with a zone of markedly slow conduction was identified. Linear ablation performed across the most accessible part of the circuit cured 16 patients (73%) with a follow-up of 15+/-7 months.
LA reentrant tachycardias are related to individually varying circuits and are amenable to mapping guided radiofrequency ablation.
典型的右心房峡部依赖性房扑已被详细描述，但对于左心房（LA）房扑却知之甚少。
我们对22例非典型房扑患者进行了左心房的传统及三维标测。17例患者的完整标测显示存在大折返环（n = 15），有1至3个环围绕二尖瓣环、肺静脉以及一个阻滞区或静区旋转。在2例患者中，识别出一个具有明显缓慢传导区的小折返环。在折返环最易接近的部位进行线性消融，使16例患者（73%）得到治愈，随访时间为15±7个月。
左心房折返性心动过速与个体不同的折返环相关，并且适合在标测引导下进行射频消融。
