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作者

Yiwei Lai, Mingyang Gao, Qifan Li, Mengmeng Li, Jianghua Zhang, Xuexun Li, Qi Guo, Lihong Huang, Chenxi Jiang, Songnan Li, Xueyuan Guo, Song Zuo, Nian Liu, Wei Wang, Xin Zhao, Caihua Sang, Ribo Tang, Deyong Long, Jianzeng Dong, Changsheng Ma

作者单位

Affiliations ¹ Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China (Y.L., M.G., Q.L., M.L., Q.G., L.H., C.J., S.L., X.G., S.Z., N.L., W.W., X.Z., C.S., R.T., D.L., C.M.). ² National Clinical Research Center for Cardiovascular Diseases, Beijing, China (Y.L., M.G., Q.L., M.L., Q.G., L.H., C.J., S.L., X.G., S.Z., N.L., W.W., X.Z., C.S., R.T., D.L., C.M.). ³ First Affiliated Hospital of Xinjiang Medical University, China (J.Z., J.D.). ⁴ Shandong Provincial Hospital Affiliated to Shandong First Medical University, China (X.L.).

刊名

Circulation. Arrhythmia and electrophysiology

年份

2024

卷号

Vol.17 No.5

页码

e012513

ISSN

1941-3084

关键词

atrioventricular reentrant tachycardia catheter ablation electrocardiogram pre-excitation syndrome.

摘要

Background: The anatomy of myocardial fibers around the right cardiac veins and their roles in accessory pathways are rarely reported. Methods: Six RCV-APs were identified from 566 patients with right-sided APs. Mapping of retrograde atrial activation was performed using CARTO 3 system under orthodromic tachycardia or right ventricular pacing. Venography of RCVs was acquired at the earliest retrograde atrial activation. Results: Patients enrolled had a median age of 30 years, 5 of them were m...更多

Background: The anatomy of myocardial fibers around the right cardiac veins and their roles in accessory pathways are rarely reported. Methods: Six RCV-APs were identified from 566 patients with right-sided APs. Mapping of retrograde atrial activation was performed using CARTO 3 system under orthodromic tachycardia or right ventricular pacing. Venography of RCVs was acquired at the earliest retrograde atrial activation. Results: Patients enrolled had a median age of 30 years, 5 of them were male. Venography of RCVs could be classified into 3 distinct patterns based on the identified ventricular branches, right marginal vein only , both right marginal vein and anterior cardiac veins , and anterior cardiac vein only . Patients with type I venography had rS QRS pattern in lead V, negative delta wave in lead III and negative or isoelectric delta wave in lead aVF. However, patients with type II and III venography had QS QRS patterns in lead V and variable patterns of delta wave in inferior leads. Earliest retrograde atrial activation was found at a median of 16.75 mm away from the tricuspid annulus, all with A larger than V. At the earliest retrograde atrial activation, far-field ventricular electrogram was found 30 ms later than QRS onset in 1 patient under sinus rhythm. AP conduction was eliminated by mechanical pressure in 2 and by radiofrequency ablation in 4 at the ostium of the veins colocalizing with the earliest retrograde activation of the right atrium. No recurrence was observed during 36 months follow-up. Conclusions: The RCV-AP is a rare form of right-sided APs characterized by atrial insertions distant from the annulus. ECG-speculated ventricular insertion sites conformed to the location of identified RCVs.收起

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