Electrogramas auriculares endocárdicos anormales en pacientes de la tercera edad con fibrilación auricular paroxística idiopática
Palabras clave:
tercera edad, fibrilación auricular paroxística idiopática, miocardio auricular; mapeo auricular endocárdico con catéterResumen
Los pacientes de la tercera edad están particularmente predispuestos a desarrollar episodios de fibrilación auricular paroxística (FAP), pudiendo ser los cambios que experimenta el miocardio auricular un factor contribuyente a la aparición de este fenómeno con el correr de los años. Por ende, diseñamos este trabajo con la idea de investigar los cambios que se producen en los electrogramas auriculares endocárdicos registrados por medio de un mapeo intraauricular con catéter en pacientes con FAP idiopática en la tercera edad. Realizamos un mapeo endocárdico con catéter de la aurícula derecha en ritmo sinusal en 72 pacientes con FAP idiopática para evaluar la influencia de la edad avanzada en los electrogramas auriculares endocárdicos. Los electrogramas bipolares fueron registrados de 12 sitios de la aurícula derecha, y un electrograma endocárdico auricular anormal fue definido como aquel que posee una duración ≥100 ms, y/o 8 o más deflexiones fragmentadas. Se registraron 864 electrogramas auriculares endocárdicos que fueron analizados cuantitativamente. El número de electrogramas auriculares anormales, así como la máxima duración y el mayor número de deflexiones fragmentadas de los electrogramas auriculares endocárdicos en los pacientes con FAP idiopática tuvo una correlación significativamente positiva con la edad. Se observó que la edad avanzada altera las propiedades electrofisiológicas del miocardio auricular haciéndolo más susceptible a desarrollar episodios de FAP. Estos cambios electrofisiológicos son más extensos conforme aumenta la edad. Existe un aumento progresivo en la extensión de la anormalidad electrofisiológica del miocardio auricular en pacientes de la tercera edad con fibrilación auricular paroxística idiopática.
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