Landolina Maurizio, Petracci Barbara, De Ferrari Gaetano M, Frattini Folco, Cantù Francesco, Rordorf Roberto, De Filippo Paolo
Electrophysiology and Arrhythmia Unit, Department of Cardiology, IRCCS Policlinico San Matteo, Pavia, Italy.
Ital Heart J. 2004 Nov;5(11):872-5.
Paroxysmal atrial fibrillation is often initiated by foci in the pulmonary veins (PVs); the junction between the PVs and the left atrium (LA) has become the target of radiofrequency (RF) ablation performed to isolate the PVs. Ectopic atrial beats originating from the PVs propagate to the LA with a characteristically long conduction time, often with a conduction delay or block within the PV or at the PV-LA junction. However, details about the conduction properties within the PVs and across the PV-LA junction are still scanty. We report a unique case of LA-PV decremental conduction caused by RF applications. New insights into the electroanatomical characteristics of the PV-LA junction are provided. The present report demonstrates, for the first time in humans, that decremental conduction may be related to the progressive damage of the conducting myocardial bundle due to RF energy applications.
阵发性心房颤动常由肺静脉（PVs）内的病灶引发；肺静脉与左心房（LA）的交界处已成为为隔离肺静脉而进行射频（RF）消融的靶点。源自肺静脉的异位心房搏动以特征性的长传导时间传播至左心房，常在肺静脉内或肺静脉-左心房交界处出现传导延迟或阻滞。然而，关于肺静脉内及跨肺静脉-左心房交界处的传导特性的细节仍很匮乏。我们报告了一例因射频应用导致左心房-肺静脉递减传导的独特病例。提供了关于肺静脉-左心房交界处电解剖特征的新见解。本报告首次在人体中证明，递减传导可能与射频能量应用导致的传导心肌束的渐进性损伤有关。
