Abstract：
A previous study reported primary macroreentrant atrial tachycardia (AT) in the left atrium (LA), including the epicardial circuit on a left atrial anterior wall (LAAW) scar, without any prior cardiac intervention (Miyazawa et al. in J Cardiovasc Electrophysiol 2019; 30: 263-264). However, determining the target for terminating macroreentrant ATs is challenging. The mapping revealed a centrifugal pattern but did not fully elucidate the AT circuit. The reentrant mechanism of these ATs was confirmed using entrainment pacing. The earliest excitation site (EES) was traditionally selected as the ablation site, typically located in healthy tissue. However, our two cases provide new insights into AT termination, including the epicardial bridge across the endocardial LAAW scar, using minimum ablation points, without the need to ablate the healthy EES.
摘要：
先前的研究报道了左心房（LA）的原发性大折返性房性心动过速（AT），包括左心房前壁（LAAW）疤痕上的心外膜回路，没有任何事先的心脏干预(Miyazawa等人。2019年J心血管电生理杂志；30：263-264）。然而,确定终止宏观可重入AT的目标是具有挑战性的。映射显示了离心模式，但未完全阐明AT电路。使用夹带起搏证实了这些AT的折返机制。传统上选择最早的激发部位(EES)作为消融部位,通常位于健康组织中。然而,我们的两个案例为AT终止提供了新的见解，包括穿过心内膜LAAW疤痕的心外膜桥,使用最小消融点，不需要消融健康的EES。
