Oi Maki, Nomura Shinnosuke, Miho Mitsunori, Kobayashi Takayasu, Okabayashi Marie, Higami Hirooki, Onishi Naoaki, Higashitani Nobuya, Saijo Sayaka, Nakazeki Fumiko, Oyamada Naofumi, Jinnai Toshikazu, Terada Shohei, Osaki Shota, Horii Katsutoshi, Kaitani Kazuaki
Department of Cardiovascular Medicine Japanese Red Cross Otsu Hospital Otsu Japan.
Department of Medical Engineering Japanese Red Cross Otsu Hospital Otsu Japan.
J Arrhythm. 2020 Sep 10;36(6):1096-1099. doi: 10.1002/joa3.12425. eCollection 2020 Dec.
A 77-year-old woman with symptomatic paroxysmal atrial fibrillation (PAF) underwent pulmonary vein isolation (PVI), but subsequently experienced recurrence. In the second session, unidirectional left atrium (LA)-left superior pulmonary vein (LSPV) conduction was revealed to exist at the carina of the LSPV. Left pulmonary vein (LPV) pacing performed in a cycle between 300 and 260 ms revealed rate-dependent pulmonary vein (PV)-LA conduction, and the location was estimated to be in the roof of the LSPV. PV isolation was achieved after ablation of two gaps. Consideration of the presence of rate-dependent gaps may be useful to confirm bidirectional block lines after ablation.
一名77岁有症状的阵发性心房颤动（PAF）女性接受了肺静脉隔离（PVI），但随后复发。在第二次手术中，发现在左上肺静脉（LSPV）隆突处存在单向左心房（LA）-LSPV传导。在300至260毫秒的周期内进行左肺静脉（LPV）起搏显示出频率依赖性肺静脉（PV）-LA传导，其位置估计在LSPV的顶部。在消融两个间隙后实现了PV隔离。考虑频率依赖性间隙的存在可能有助于确认消融后的双向阻滞线。
