Paydak Hakan, Piros Priscilla, Scheinman Melvin M, Dorostkar Parvin C
Departments of Pediatrics and Internal Medicine, University Hospitals of Cleveland, Cleveland, Ohio, USA.
J Electrocardiol. 2003 Apr;36(2):105-10. doi: 10.1053/jelc.2003.50016.
Atriofascicular pathways supporting antidromic reentrant tachycardia are uncommon, and may be difficult to ablate. Traditional mapping can be associated with traumatic loss of atriofascicular conduction. Atriofascicular fibers can insert into the right bundle and will, therefore, first activate the right ventricle. In contrast to initial activation of the ventricle near the tricuspid annulus that can be seen in patients with right-sided decremental atrioventricular pathways. We used electroanatomic mapping to map and ablate the ventricular insertion of atriofascicular pathways in two patients during sinus rhythm and during atrial pacing. In our 2 cases an atriofascicular potential was recorded from below the tricuspid valve annulus and tagged. At this site, each pathway was ablated with one radiofrequency lesion. We describe 2 cases where electroanatomic mapping of the right ventricle was used to map and ablate atriofascicular pathways.
支持逆向折返性心动过速的房室束旁道并不常见，且可能难以消融。传统标测可能会导致房室束旁道传导的创伤性丧失。房室束旁纤维可插入右束支，因此会首先激动右心室。这与右侧递减型房室旁道患者中可见的三尖瓣环附近心室的初始激动不同。我们使用电解剖标测在两名患者的窦性心律和心房起搏期间对房室束旁道的心室插入部位进行标测和消融。在我们的2例患者中，在三尖瓣环下方记录到房室束旁电位并进行标记。在该部位，每条旁道用一个射频消融灶进行消融。我们描述了2例使用右心室电解剖标测来标测和消融房室束旁道的病例。
