Cargando…

Right atrial appendage: an important structure to drive atrial fibrillation

PURPOSE: Understanding of the atrial fibrillation (AF) driven by right atrial appendage (RAA) is limited. This study aimed to understand the characteristics of the AF driven by RAA and explore ablation methods. METHODS: This was a retrospective study and patients who were identified as having the AF...

Descripción completa

Detalles Bibliográficos
Autores principales: Liu, Yang, Song, Ziliang, Jiang, Weifeng, Wu, Shaohui, Liu, Xu, Qin, Mu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550756/
https://www.ncbi.nlm.nih.gov/pubmed/35179671
http://dx.doi.org/10.1007/s10840-021-01106-8
_version_ 1784805951954485248
author Liu, Yang
Song, Ziliang
Jiang, Weifeng
Wu, Shaohui
Liu, Xu
Qin, Mu
author_facet Liu, Yang
Song, Ziliang
Jiang, Weifeng
Wu, Shaohui
Liu, Xu
Qin, Mu
author_sort Liu, Yang
collection PubMed
description PURPOSE: Understanding of the atrial fibrillation (AF) driven by right atrial appendage (RAA) is limited. This study aimed to understand the characteristics of the AF driven by RAA and explore ablation methods. METHODS: This was a retrospective study and patients who were identified as having the AF driven by RAA were reviewed. Ablation was performed during AF. Potential maps of the left and right atrium, electrophysiological examinations, and ablation methods were studied. RESULTS: Among the 20 identified patients (mean age 67.0 ± 11.2 years; ejection fraction 62.9 ± 6.0%; LA diameter 43.1 ± 4.9 mm; RA diameter 51.7 ± 8.3 × 42.9 ± 3.7 mm), the AF cycle length in RAA (134.0 ± 10.9 ms) was the shortest, and the fastest frequency potentials were located in the RAA in 65% of patients. For the left atrium, the AF cycle length of the roof (145.5 ± 14.9 ms) was the shortest, followed by the left atrial appendage (153.7 ± 17.1 ms) and bottom (154.8 ± 11.8 ms). High-frequency potentials of RAA could be rapidly conducted to left atrium via sagittal bundle and Bachmann’s bundle, and the conduction time (55.0 ± 5.0 ms) was significantly shorter than the mean bi-atrial activation time (176.7 ± 10.3 ms, P < 0.0001). AF could be terminated after ablation at the RAA base (17 patients) or mechanical stimulation within the RAA (3 patients). To date, only two patients had recurrent atrial flutter, while the remaining patients maintained sinus rhythm. CONCLUSION: The AF driven by RAA is characterized by high-frequency potentials in RAA, and ablation at the RAA base can achieve a satisfactory therapeutic effect. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10840-021-01106-8.
format Online
Article
Text
id pubmed-9550756
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-95507562022-10-12 Right atrial appendage: an important structure to drive atrial fibrillation Liu, Yang Song, Ziliang Jiang, Weifeng Wu, Shaohui Liu, Xu Qin, Mu J Interv Card Electrophysiol Article PURPOSE: Understanding of the atrial fibrillation (AF) driven by right atrial appendage (RAA) is limited. This study aimed to understand the characteristics of the AF driven by RAA and explore ablation methods. METHODS: This was a retrospective study and patients who were identified as having the AF driven by RAA were reviewed. Ablation was performed during AF. Potential maps of the left and right atrium, electrophysiological examinations, and ablation methods were studied. RESULTS: Among the 20 identified patients (mean age 67.0 ± 11.2 years; ejection fraction 62.9 ± 6.0%; LA diameter 43.1 ± 4.9 mm; RA diameter 51.7 ± 8.3 × 42.9 ± 3.7 mm), the AF cycle length in RAA (134.0 ± 10.9 ms) was the shortest, and the fastest frequency potentials were located in the RAA in 65% of patients. For the left atrium, the AF cycle length of the roof (145.5 ± 14.9 ms) was the shortest, followed by the left atrial appendage (153.7 ± 17.1 ms) and bottom (154.8 ± 11.8 ms). High-frequency potentials of RAA could be rapidly conducted to left atrium via sagittal bundle and Bachmann’s bundle, and the conduction time (55.0 ± 5.0 ms) was significantly shorter than the mean bi-atrial activation time (176.7 ± 10.3 ms, P < 0.0001). AF could be terminated after ablation at the RAA base (17 patients) or mechanical stimulation within the RAA (3 patients). To date, only two patients had recurrent atrial flutter, while the remaining patients maintained sinus rhythm. CONCLUSION: The AF driven by RAA is characterized by high-frequency potentials in RAA, and ablation at the RAA base can achieve a satisfactory therapeutic effect. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10840-021-01106-8. Springer US 2022-02-18 2022 /pmc/articles/PMC9550756/ /pubmed/35179671 http://dx.doi.org/10.1007/s10840-021-01106-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Liu, Yang
Song, Ziliang
Jiang, Weifeng
Wu, Shaohui
Liu, Xu
Qin, Mu
Right atrial appendage: an important structure to drive atrial fibrillation
title Right atrial appendage: an important structure to drive atrial fibrillation
title_full Right atrial appendage: an important structure to drive atrial fibrillation
title_fullStr Right atrial appendage: an important structure to drive atrial fibrillation
title_full_unstemmed Right atrial appendage: an important structure to drive atrial fibrillation
title_short Right atrial appendage: an important structure to drive atrial fibrillation
title_sort right atrial appendage: an important structure to drive atrial fibrillation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9550756/
https://www.ncbi.nlm.nih.gov/pubmed/35179671
http://dx.doi.org/10.1007/s10840-021-01106-8
work_keys_str_mv AT liuyang rightatrialappendageanimportantstructuretodriveatrialfibrillation
AT songziliang rightatrialappendageanimportantstructuretodriveatrialfibrillation
AT jiangweifeng rightatrialappendageanimportantstructuretodriveatrialfibrillation
AT wushaohui rightatrialappendageanimportantstructuretodriveatrialfibrillation
AT liuxu rightatrialappendageanimportantstructuretodriveatrialfibrillation
AT qinmu rightatrialappendageanimportantstructuretodriveatrialfibrillation