Loading…

A simple pacing maneuver to unmask an epicardial connection involving the right‐sided pulmonary veins

Introduction An epicardial connection (EC) between the right‐sided pulmonary venous (PV) carina and right atrium (RA) is one of the mechanisms for which carinal ablation is required for right‐sided PV isolation. The purpose of the study was to devise a simple pacing maneuver to differentiate an EC f...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2021-02, Vol.32 (2), p.287-296
Main Authors: Hasebe, Hideyuki, Yoshida, Kentaro, Nogami, Akihiko, Furuyashiki, Yoshitaka, Hanaki, Yuichi, Baba, Masako, Ieda, Masaki
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction An epicardial connection (EC) between the right‐sided pulmonary venous (PV) carina and right atrium (RA) is one of the mechanisms for which carinal ablation is required for right‐sided PV isolation. The purpose of the study was to devise a simple pacing maneuver to differentiate an EC from a residual conduction gap on the antral ablation line during radiofrequency catheter ablation. Methods and Results This study included 133 consecutive patients. After one round of ablation, electrograms at the posterior antrum outside the ablation line were recorded during sinus rhythm (SR) and coronary sinus (CS) pacing, and intervals between the antral and PV potentials were measured in each rhythm. The ΔintervalSR‐CS was calculated as the difference between the interval during SR and that during CS pacing. Presence of an EC was confirmed by observation of a RA posterior wall breakthrough during right‐sided PV pacing, which was then targeted for ablation. Patients with nonachievement of first‐pass isolation (N = 35) and with PV reconnection during the procedure (N = 9) were classified into the EC‐group (N = 20) and gap‐group (N=24), respectively. The prevalence of carina breakthrough during SR was higher in the EC‐group than the gap‐group (18 [95%] vs. 1 [4%] patients, p 
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.14835