Lengthening the atrioventricular delay reduces large left atrial v waves and dyspnea after atrial fibrillation and tachycardia ablation Raman Mitra,

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Presentation transcript:

Lengthening the atrioventricular delay reduces large left atrial v waves and dyspnea after atrial fibrillation and tachycardia ablation Raman Mitra, MD, PhD, FHRS HeartRhythm Case Reports Volume 3, Issue 12, Pages 590-594 (December 2017) DOI: 10.1016/j.hrcr.2017.09.007 Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 1 Patient 1: Atrioventricular delay (AVD) effects on left and right atrial pressures with respect to intracardiac left atrial appendage (LAA) electrograms (EGMs). Column 1 Baseline AVD 150 ms: (A) left atrial (LA) pressures @ 30-mm scale, (D) LAA electrograms occurring at 118 ms after the atrial pacing spike, and (G) right atrial (RA) pressure @ 30-mm scale at an AVD of 150 ms. Column 2 Postablation AVD 150 ms: (B) LA pressures @ 50-mm scale with large v waves, (E) LAA electrograms now delayed to 306 ms after the QRS with the delayed left atrial P wave in the ST segment (yellow oval), and (H) RA pressure. Column 3 Postablation AVD 350 ms: (C) reduction of LA v waves @ 50-mm scale, (F) LA electrograms and delayed LA P wave (yellow oval) now occurring before the QRS, and (I) elevation of RA a waves @ 30-mm scale HeartRhythm Case Reports 2017 3, 590-594DOI: (10.1016/j.hrcr.2017.09.007) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 2 Patient 1: Pacemaker log showing reduction of atrial tachycardia/atrial fibrillation (AT/AF) burden postablation. HeartRhythm Case Reports 2017 3, 590-594DOI: (10.1016/j.hrcr.2017.09.007) Copyright © 2017 Heart Rhythm Society Terms and Conditions

Figure 3 Patient 2: Activation time to left atrial appendage preablation (75 ms) and postablation (114 ms). Note: Cardiac resynchronization therapy pacing was turned off during measurements but was initially set at 110 ms, and upon reviewing these data, it was reprogrammed to 160 ms with resolution of symptoms of dyspnea. HeartRhythm Case Reports 2017 3, 590-594DOI: (10.1016/j.hrcr.2017.09.007) Copyright © 2017 Heart Rhythm Society Terms and Conditions