Confined thoracic vein fibrillation: prevalence and electrophysiological properties
| Autor: | Yoshito Iesaka, Hitoshi Hachiya, Hiroshi Taniguchi, Shinsuke Miyazaki, Shigeki Kusa, Kenzo Hirao, Jin Iwasawa, Akio Kuroi |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Thoracic Vein Pulmonary vein Electrocardiography Japan Superior vena cava Heart Conduction System Internal medicine Atrial Fibrillation Prevalence Medicine Humans Sinus rhythm Vein Fibrillation business.industry Atrial fibrillation Middle Aged medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Pulmonary Veins cardiovascular system Cardiology Catheter Ablation Female medicine.symptom Cardiology and Cardiovascular Medicine business Cardioversions Follow-Up Studies |
| Zdroj: | American heart journal. 167(4) |
| ISSN: | 1097-6744 |
| Popis: | Introduction Confined thoracic vein fibrillation (cTVT) is a finding that suggests that thoracic vein acts as a rapid driver to maintain atrial fibrillation (AF). However, little is known about the cTVT. Methods and Results Among consecutive 655 patients (age 62 ± 0 years, 492 men, 421 paroxysmal) who underwent circumferential pulmonary vein (PV) antrum isolation for AF, cTVT was identified in 28 (4.3%) patients. The prevalence was significantly higher in patients with paroxysmal AF than in those with nonparoxysmal AF (5.9% vs 1.3%, P = .002). The cTVT was observed in left PVs in 15 (53.6%), right PVs in 11 (39.3%), and superior vena cava in 2 (7.1%) patients. The median cycle length of cTVT was 150 (110-170) ms. The cTVT was recognized when sinus rhythm was restored from AF during vein isolation in 14 patients. Dissociated activity was seen after the termination of cTVT in 23 (82.1%) patients, and cTVT reinitiated spontaneously after the dissociated activity. In 2 patients, AF was not terminated by multiple cardioversions before the isolation, even with a maximal energy delivery. At a median follow-up of 12.0 (7.5-20.5) months, 26 patients (92.9%) were free from AF without antiarrhythmic drugs after a mean of 1.4 ± 0.5 procedures per patient. Notably, recurrent arrhythmia was not observed in any patient (n = 6), wherein cTVT was terminated by additional radiofrequency applications inside an isolated area after the achievement of vein isolation. Conclusions Confined thoracic vein fibrillation is not a rare finding in patients with paroxysmal AF, and its elimination results in an excellent clinical outcome. |
| Databáze: | OpenAIRE |
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