Identifying the Origin of Right and Left Ectopic Atrial Beats Triggering Atrial Fibrillation before Atrial Transseptal Procedure
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- Ohkubo Kimie
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Watanabe Ichiro
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Okumura Yasuo
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Yamada Takeshi
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Ashino Sonoko
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Hashimoto Kenichi
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Shindo Atsushi
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Sugimura Hidezou
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Nakai Toshiko
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Ozawa Yukio
- Department of Cardiovascular Disease, Nihon University School of Medicine
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- Saito Satoshi
- Department of Cardiovascular Disease, Nihon University School of Medicine
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Abstract
Atrial premature depolarizations (APDs) triggering atrial fibrillation (AF) originate from mainly the pulmonary veins (PVs), but, in some cases, atrial ectopic beats (AEBs) triggering AF originate from the right atrium (RA) or the superior vena cava. Accurate identification of the origin of APDs in the PVs by means of RA and coronary sinus mapping is difficult. Purpose: The aim of this study was to identify the origin of AEBs triggering AF before transseptal catheterization. Electrode catheters were placed in the posteroseptal RA (PSRA), right pulmonary artery (RPA), left pulmonary artery (LPA), and esophagus in 10 patients with paroxysmal AF. We analyzed endocardial electrograms from the PSRA, RPA and LPA, and epicardial electrograms from the esophagus. The origin of the AEBs in the PVs was determined before PV ablation by mapping 4 PVs simultaneously. Four AEBs originated from the left superior PV (LSPV), 2 from the left inferior PV (LIPV), 4 from the right superior PV (RSPV), 2 from the RA or superior vena cava. In AEBs originating from the RA, the PSRA activation was the earliest and it proceeded in a cranial to caudal direction. In AEBs originating from the RUPV, RPA was the earliest. The esophageal activation sequence was in a cranial to caudal direction. In AEBs from the LSPV, LPA was the earliest and the esophageal activation sequence proceeded in a cranial to caudal direction. In AEDs from LIPV, LPA was the earliest, and the esophageal activation sequence was nearly simultaneous. Atrial activation sequences from the PSRA, RPA, LPA, and esophageal catheters can accurately identify the location of the initiating foci of AF before a transseptal procedure.
Journal
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- Journal of Arrhythmia
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Journal of Arrhythmia 22 (4), 216-224, 2006
Japanese Heart Rhythm Society
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Details 詳細情報について
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- CRID
- 1390001205246157440
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- NII Article ID
- 10018487281
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- NII Book ID
- AA12059301
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- ISSN
- 18832148
- 18804276
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- Text Lang
- en
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed