The Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) Expert Consensus Statement on the perioperative management of patients with implantable defibrillators, pacemakers and arrhythmia monitors: facilities and patient management this document was developed as a joint project with the American Society of Anesthesiologists (ASA), and in collaboration with the American Heart Association (AHA), and the Society of Thoracic Surgeons (STS).

摘要

A 57-year-old man with symptomatic recurrent atrial fibrillation after a prior pulmonary vein (PV) isolation procedure was brought to the electrophysiology laboratory for a repeat ablation procedure. At the start of the procedure, a circular mapping catheter was placed within the left superior pulmonary vein (LSPV). Electrogram analysis demonstrated an initial low-frequency (Figure 1 A, arrow) and a second high-frequency (Figure 1A, asterisk) potential consistent with reconnection of the LSPV. A single radiofrequency lesion was placed, resulting in loss of the second high-frequency electrogram, which suggested reisolation of the LSPV. The remaining high-frequency electrograms located on the anterior aspect of the PV were thought to represent far-field signals from the left atrial appendage (LAA).