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Aleteo atrial septal izquierdo: electrofisiología, anatomía y resultados de la ablación
Nassir F Marrouche1, Andrea Natale, Oussama M Wazni
1Section of Pacing and Electrophysiology, Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Circulation
|May 12, 2004
Resumen
Este estudio identifica un nuevo tipo de circuito de aleteo auricular izquierdo, a menudo relacionado con el uso de medicamentos antiarrítmicos. La ablación por radiofrecuencia dirigida al septo primum y al anillo mitral curó efectivamente la taquicardia en la mayoría de los pacientes.
Área de la Ciencia:
- Cardiología Cardiología.
- Electrofisiología y electrofisiología.
- Investigación médica Investigación médica.
Sus antecedentes:
- Describe una nueva forma macroreintrante de aleteo auricular izquierdo.
- Investiga las características clínicas y electrofisiológicas de esta arritmia.
Objetivo del estudio:
- Para caracterizar un circuito de aleteo auricular izquierdo recientemente identificado.
- Evaluar la eficacia y seguridad de la ablación por radiofrecuencia para este aleteo específico.
Principales métodos:
- Se incluyeron 11 pacientes con aleteo auricular izquierdo.
- Utilizó sistemas de marcado y mapeo de arrastre (CARTO Biosense o convencional).
- Se realiza una ablación por radiofrecuencia dirigida a regiones anatómicas específicas (septum primum a las venas pulmonares o anillo mitral).
Principales resultados:
- El circuito de aleteo giraba alrededor del septo primario izquierdo con un istmo crítico.
- La ablación desde el septo primum hasta el anillo mitral (6 pacientes) no dio lugar a una recurrencia después de 13 meses.
- La ablación desde el tabique primario a la vena pulmonar inferior derecha (5 pacientes) tuvo una recurrencia en 2 pacientes.
Conclusiones:
- El aleteo atrial septal izquierdo puede ser promovido por una conducción más lenta debido a medicamentos antiarrítmicos o miopatía auricular.
- La ablación por radiofrecuencia es generalmente efectiva y segura para tratar esta arritmia.
- Las líneas de ablación desde el tabique primario hasta el anillo mitral demostraron una alta eficacia para la curación de la taquicardia.
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