Quantitative Analysis of Surface P-Wave Morphology in Isthmus Ablation for Type 1 Atrial Flutter : Differentiation Between Complete Isthmus Block and Slow Isthmus Conduction
スポンサーリンク
概要
- 論文の詳細を見る
Changes in P-wave morphology in inferior leads during atrial pacing at the margins of the carvo-tricuspid isthmus have been reported to be useful for predicting the creation of isthmus block in radiofrequency (RF) ablation of type 1 atrial flutter (AFL). However, it is not known whether these changes in P-wave morphology allow the clinician to differentiate between complete isthmus block and slow isthmus conduction. P-wave morphology during low lateral right atrial (LLRA) pacing, as well as during coronary sinus ostium (PCS) pacing, was evaluated prior to ablation, during slow isthmus conduction, and after complete isthmus block in 30 patients with AFL. Changes in P-wave morphology during LLRA pacing were not sufficient to differentiate between complete isthmus block and slow isthmus conduction. While changes in P-wave morphology in lead II from inverted to biphasic during PCS pacing were observed in both slow isthmus conduction and complete isthmus block, the ratio of the positive component to the total P-wave amplitude (P-wave ratio) was significantly different between slow isthmus conduction (20±17%) and complete isthmus block (40±11%)(P<0.0001). When the P-wave ratio in lead II during PCS pacing was more than 75% of the F-wave ratio in lead II during AFL, bilateral complete isthmus block was predicted with a sensitivity of 88%, a specificity of 71%, a positive predictive value of 75%, and a negative predictive value of 85%. These results indicate that a P-wave ratio greater than 20% or a P-wave ratio during PCS pacing greater than 75% of the F-wave ratio during AFL may predict a bidirectional complete isthmus block.
- 社団法人日本循環器学会の論文
- 1999-03-20
著者
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Nogami Akihiko
Cardiology Division, Yokohama Rosai Hospital
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Tada Hiroshi
Cardiology Department of Internal Medicine, Univercity of Tsukuba Graduate School of Comprehensive H
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内藤 滋人
Division Of Cardiology Gunma Prefectural Cardiovascular Center
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Hoshizaki Hiroshi
Cardiology Division, Gunma Prefectural Carotovascular Center
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Taniguchi Koichi
Cardiology Division, Gunma Prefectural Carotovascular Center
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NAITO Shigeto
Cardiology Division, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
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OSHIMA Shigeru
Cardiology Division, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
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Nogami Akihiko
Cardiology Division Yokohama Rosai Hospital
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Horie Yasuto
Division Of Cardiology Gunma Prefectural Cardiovascular Center
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Suguta Masahiko
Department Of Dermatology Gunma University Graduate School Of Medicine
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Hori Yasuhiko
Gunma Prefectural Cardiovascular Center
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Ohshima Shigeru
Gunma Prefectural Cardiovascular Center
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Suguta Masahiko
Department Of Cardiovasucular Medicine Fukui University Hospital
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Horie Yasuto
Cardiology Division, Gunma Prefectural Cardiovascular Center
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Suguta Masahiko
Cardiology Division, Gunma Prefectural Cardiovascular Center
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Nakatsugawa Masatoshi
Cardiology Division, Gunma Prefectural Cardiovascular Center
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Sekiguchi Makoto
Department Of Cardiovasucular Medicine Fukui University Hospital
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Nakatsugawa Masatoshi
Cardiology Division Gunma Prefectural Cardiovascular Center
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Suguta Masahiko
Cardiology Division Gunma Prefectural Cardiovascular Center
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Taniguchi Koichi
Cardiology Division Gunma Prefectural Cardiovascular Center
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Naito Shigeto
Cardiology Division Gunma Cardiovascular Center
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Hoshizaki Hiroshi
Cardiology Division, Gunma Prefectural Cardiovascular Center
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