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Características electrocardiográficas superficiales del aleteo auricular derecho e izquierdo
Andres Bochoeyer1, Yanfei Yang, Jie Cheng
1Cardiovascular Research Institute and Section of Cardiac Electrophysiology, University of California, San Francisco 94143-1354, USA.
Circulation
|July 2, 2003
Resumen
Se describen los patrones de ECG de superficie para el aleteo auricular (AFL) no dependiente del istmo cavotricuspid (CTI). Algunos patrones de aleteo auricular derecho (AR) pueden ser dependientes de la ITC, mientras que la reentrada del bucle superior imita el sentido de las agujas del reloj de la ITC AFL.
Área de la Ciencia:
- Electrofisiología y electrofisiología.
- Cardiología Cardiología.
- Imágenes médicas de imágenes médicas.
Sus antecedentes:
- Comprensión limitada de las características del electrocardiograma de superficie (ECG) para los circuitos de aleteo atrial derecho (RA) y atrial izquierdo (LA) no dependientes del istmo cavotricuspid (CTI).
- Necesidad de criterios de diagnóstico más claros para diferenciar varios mecanismos de aleteo auricular (AFL).
Objetivo del estudio:
- Para investigar y caracterizar los patrones de ECG de superficie asociados con los circuitos de aleteo RA y LA no dependientes de CTI.
- Para comparar estos patrones con AFL conocido dependiente de CTI (en sentido contrario a las agujas del reloj [CCW] y en sentido horario [CW]) para identificar características distintivas.
Principales métodos:
- Análisis retrospectivo de 32 episodios de aleteo atípico de AR y 22 episodios de aleteo de AL en 26 y 21 pacientes, respectivamente.
- Evaluación de las características de ECG superficiales, incluidas las secuencias de activación y las desviaciones de plomo, en relación con circuitos de aleteo específicos (reentrada en el bucle inferior, reentrada en el bucle superior, tabique, otros circuitos de LA).
Principales resultados:
- El aleteo RA de reentrada en el bucle inferior mostró patrones de ECG similares a CCW CTI AFL pero con fuerzas terminales reducidas en los cables inferiores.
- El aleteo de reingreso en el bucle superior de RA (7/8 episodios) imitaba a CW CTI AFL.
- Los circuitos septal de LA (11 pacientes) se presentaron con fuerzas prominentes de V1 y deflexiones planas en otros lugares.
- Otros circuitos de LA (11 pacientes) tenían patrones variables con disminución de la tensión de plomo inferior en comparación con CCW CTI AFL.
Conclusiones:
- Los patrones de aleteo auricular derecho distintos de CCW o CW CTI AFL todavía pueden ser dependientes de CTI.
- La reentrada del bucle superior demuestra un patrón de superficie AFL CW CTI consistente y no es dependiente de CTI.
- Los circuitos de aleteo auricular izquierdo suelen exhibir fuerzas de plomo inferiores planas o de baja amplitud.
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