Yamashita Seigo, Hooks Darren A, Cheniti Ghassen, Jais Pierre
Hôpital Cardiologique du Haut-Lévêque, Université de Bordeaux, LIRYC Institute: IHU LIRYC ANR-10-IAHU-04 and Equipex MUSIC ANR-11-EQPX-0030, Avenue de Magellan, Bordeaux-Pessac, 33604, France.
Pacing Clin Electrophysiol. 2018 Jun;41(6):666-668. doi: 10.1111/pace.13278. Epub 2018 Feb 2.
We report a case of recurrent focal atrial tachycardia (AT) which mechanisms could be resolved by using noninvasive electrocardiographic imaging (ECGI) reconstructing epicardial potentials and rapid high-density endocardial contact mapping (Rhythmia™, Boston Scientific, Natick, MA, USA). ECGI demonstrated focal activity from the anterior of the left superior pulmonary vein antrum, although Rhythmia™ showed focal activity from the high anterior left atrium with the 2 focus originating from the site where identical to the focus on the ECGI map with slightly delay (by 8 ms). Elimination of the AT by radiofrequency applications for both of the endocardial focuses indicated the dual endocardial exits from an epicardial focus.
我们报告一例复发性局灶性房性心动过速（AT）病例，其机制可通过使用无创心电图成像（ECGI）重建心外膜电位以及快速高密度心内膜接触标测（Rhythmia™，美国波士顿科学公司，马萨诸塞州纳蒂克）来解析。ECGI显示左上肺静脉前庭前部存在局灶性活动，尽管Rhythmia™显示左心房前上部存在局灶性活动，两个病灶起源于与ECGI图上病灶相同的部位，但稍有延迟（延迟8毫秒）。通过对两个心内膜病灶进行射频消融消除了AT，这表明心外膜病灶存在双心内膜出口。
