New discovery of left atrial macroreentry tachycardia: originating from the spontaneous scarring of left atrial anterior wall
| Autor: | Zhiyuan Xu, Ruifu Zhao, yanyan jing, Zhen Wang, Lin Zhong, Naibao Hu, hongxia chu, jianping li, xuefeng zhu, chunxiao wang, wenjing li |
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| Rok vydání: | 2021 |
| Předmět: |
Tachycardia
Male medicine.medical_specialty Article Subject Anterior wall Cicatrix Left atrial Internal medicine Atrial Fibrillation medicine Diseases of the circulatory (Cardiovascular) system Humans Radiology Nuclear Medicine and imaging Heart Atria Aged Aged 80 and over business.industry Treatment Outcome RC666-701 Cardiology Catheter Ablation cardiovascular system Female medicine.symptom Cardiology and Cardiovascular Medicine business Research Article |
| Zdroj: | Journal of Interventional Cardiology Journal of Interventional Cardiology, Vol 2021 (2021) |
| Popis: | Aims: This study sought to describe originating from the spontaneous scarring of left atrial anterior wall (LAAW) left atrial macroreentry tachycardia (LAMRT) clinical and electrophysiological characteristics, mechanisms, the formation of substrates.Methods and Results: 9 of 123 patients (89% female, age 79.78±5.59 years) had LAMRT originating from the LAAW and no cardiac surgery or prior left atrial (LA) ablation. The mean tachycardia cycle length (TCL) was 241.67±38.00 milliseconds. Spontaneous scars areas and low voltage areas (LVAs) in the LAAW were found in all patients. Successful ablation of the critical isthmus caused terminated of the LAMRT and was not inducible in all patients. Arrhythmogenic substrates of LAMRT were the spontaneous scars of LAAW, which matched with the aorta or/and pulmonary artery contact area. The area under the curve (AUC) of age and combination of gender and age for predicting the LAMRT originating from the LAAW were 0.918 and 0.951, respectively, with a cutoff value of ≥73.5 years of age and gender (female) predicting LAMRT with 88.9% sensitivity and 89% specificity.Conclusion: Combination of gender and age provides a simple and useful criterion to distinguish LAMRT from cavo-tricuspid isthmus (CTI) -dependent atrial tachycardia in macroreentry atrial tachycardia (MRAT) in patients without a history of surgery or ablation. Aorta or/and pulmonary artery contacting LA may be related to spontaneous scars. Ablation the isthmus eliminated LAMRT in all patients. |
| Databáze: | OpenAIRE |
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