Методика интраоперационного эпикардиального картирования предсердий у пациентов с пароксизмальной формой фибрилляции предсердий

Objective: to work out technique of mapping plates application on the epicardial surface of the left and right atrium, getting data on the zones of myocardial atriums high activity, assess the potential of graphic representation of electrograms analysed by Fouriers transform with three-dimension atrial model. Materials and methods. Intraoperative epicardial atrial mapping was performed in 35 patients with paroxysmal atrial fibrillation 22 of whom were men and 13 women. Their age varied from 40 to 59 years, mean age was 52.6±6.79 years. Surface epicardial mapping was carried out with 81-channel system using three silicone electrodes applied on the right and left atrium. Analysis of electrogram obtained was performed with hardware and software complex Biotok. Results. Technique of epicardial mapping electrodes application on the left and right atrium was worked out. Allocation scheme of dominant frequency spectrum along the right and left atrium is developed and highly active zones in the atriums responsible for atrial fibrillation emergence and maintenance are revealed. In patients with paroxysmal atrial fibrillation dominant frequencies values over 9 Hz were noted in 43 points which were situated at the zone around the left auricle, left pulmonary veins. So mean values of dominant frequencies associated with paroxysmal atrial fibrillation around left pulmonary veins were 10.8±1.6 Hz; at the basis of the left auricle 10.3±0.8 Hz, on the roof of the left atrium 8.8±1.13 Hz, on the outside wall of the left atrium 9.0±2.4 Hz. Dominant frequencies values in the right atrium: right atrium roof 7.0±2.4 Hz, lateral wall of the right atrium 7.0 ±2.4 Hz. Conclusion. Intraoperative epicardial atrial mapping may be carried out directly at the operating room before the main stage of the surgical aid. Results of the studies reliably show the zones with high frequency signal responsible for maintenance of fibrillation.