Reentrant Tachycardia in Pulmonary Veins of Patients with Paroxysmal Atrial Fibrillation

Abstract

Reentrant tachycardia can occur in some isolated PVs with both decremental conduction properties and short refractory periods, which suggests that reentry may be one of the mechanisms of PV arrhythmogenicity.

Complete Isolation of Left Atrium Surrounding the Pulmonary Veins

“…14,15 In the present study, PVT with a CL of 188.6Ϯ32.4 ms could be reproducibly induced within the isolated PVs in 15 of 36 patients without previous SOA. Also, in patients who had not undergone SOA, spontaneous PVT with a short CL occurred in 4 patients during the first procedure and in 7 patients during the second procedure before complete isolation of all PVs.…”

“…14,15 In the present study using 2 Lasso catheters within the ipsilateral PVs, automatic activity dissociated from atrial activity after PV isolation was demonstrated in right-sided PVs in 87.8% and in left-sided PVs in 80.5%. Automatic activity occurred during the second procedure in 1 patient in whom it had not been recorded in the first procedure.…”

“…[7][8][9][10] A recent randomized study has shown that CCL is more effective in preventing PAF recurrence than SOA. 8 This may be due to the elimination of triggered activity and/or mother waves near the PV ostium that drive AF, the isolation of relatively large areas that are not available for perpetuating AF, [7][8][9][10]15 and vagal denervation by CCL. 10 In most studies using CCL, amplitude reduction within the ablation area was the only end point studied.…”

Estudio de la vulnerabilidad a reentradas a través de modelos matemáticos y simulación de la aurícula humana

“…En los estudios de las técnicas quirúrgicas MAZE 2 propuestas por Cox, se señalan regiones similares en las que se presenta mayor numero de focos de activación y se definen técnicas quirúrgicas para resolverlas (Cox et al 2000. Otros trabajos confirman estos hallazgos (Arora et al 2003, Belhassen et al 2004, Jais et al 2002, Takahashi et al 2003. En la actualidad no está totalmente claro cuáles son los mecanismos que generan y mantienen las arritmias…”

“…Si se intentara utilizar el modelo en estas condiciones, no seria posible observar un comportamiento adecuado de la actividad reentrante, ya que se sabe que esta actividad se ve fuertemente influenciada por la complejidad de anatomía en esta región (Arora et al 2003, Ho et al 1999, Takahashi et al 2003, Tsao et al 2001, Vigmond et al 2001. Por una parte es necesario que las venas pulmonares esten separadas, por un tejido conductor entre ambas.…”