Purpose

Previous studies examined the right atrial (RA) input site of the antegrade fast pathway (AFp) (AFpI). However, the left atrial (LA) input to the atrioventricular (AV) node has not been extensively evaluated. In this study, we created three-dimensional (3-D) bi-atrial stimulus-ventricle (St-V) maps and analyzed the input site and characteristics of the AFp in both the RA and LA.

Methods

Forty-four patients diagnosed with atrial fibrillation or WPW syndrome were included in this study. Three-dimensional bi-atrial St-V mapping was performed using an electroanatomical mapping system. Sites exhibiting the minimal St-V interval (MinSt-V) were defined as AFpIs and were classified into seven segments, four in the RA (F, S, M, and I) and three in the LA (M1, M2, and M3). By combining the MinSt-V in the RA and LA, the AFpIs were classified into three types: RA, LA, and bi-atrial (BA) types. The clinical and electrophysiological characteristics were compared.

Results

AFpIs were most frequently observed at site S in the RA (34%) and M2 in the LA (50%), and the BA type was the most common (57%). AFpIs in the LA were recognized in 75% of the patients. There were no clinical or electrophysiological indicators for predicting AFpI sites.

Conclusions

Three-dimensional bi-atrial St-V maps could classify AFpIs in both the RA and LA. AFpIs in the LA were frequently recognized. There were no significant clinical or electrophysiological indicators for predicting AFpI sites, and 3-D bi-atrial St-V mapping was the only method to reveal the precise AFp input site.

中文翻译：

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基于三维双心房刺激-心室映射的前向快速通路输入部位及特征评价

目的

以前的研究检查了前向快速通路 (AFp) (AFpI) 的右心房 (RA) 输入位点。然而，尚未对房室 (AV) 结的左心房 (LA) 输入进行广泛评估。在这项研究中，我们创建了三维 (3-D) 双心房刺激-心室 (St-V) 图，并分析了 RA 和 LA 中 AFp 的输入部位和特征。

方法

本研究纳入了 44 名诊断为心房颤动或 WPW 综合征的患者。使用电解剖标测系统进行三维双心房 St-V 标测。表现出最小 St-V 间期 (MinSt-V) 的部位被定义为 AFpIs，分为 7 个部分，4 个位于 RA（F、S、M 和 I），3 个位于 LA（M1、M2 和 M3） ）。通过结合 RA 和 LA 中的 MinSt-V，将 AFpis 分为三种类型：RA、LA 和双心房 (BA) 类型。比较临床和电生理特征。

结果

AFpIs 最常见于 RA 的 S 位点（34%）和 LA 的 M2 位点（50%），BA 类型最常见（57%）。75% 的患者发现了 LA 中的 AFpis。没有预测 AFpI 部位的临床或电生理指标。

结论

三维双心房 St-V 图可以对 RA 和 LA 中的 AFpis 进行分类。洛杉矶的 AFpis 经常得到认可。没有显着的临床或电生理指标来预测 AFpI 部位，3-D 双心房 St-V 映射是揭示精确 AFp 输入部位的唯一方法。