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心房扑动的心电生理特点及射频消融治疗 |
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孙英贤 陈惠斌 曾定尹 于亚媛 赵卫华 杨光
王文科 张月兰 张子新 戴旭 Westby G.Fisher
【摘要】 目的 探讨心房扑动（房扑）病例电生理特点及采用射频消融治疗房扑的效果。方法 对26例房扑患者标测心房激动顺序,用隐匿拖带方法确定折返环部位。用长导引鞘作支撑，在心房内行线性消融方法治疗房扑。结果 26例房扑中23例折返环位于三尖瓣环部位，1例位于右心房游离壁部位，1例位于左心房，另1例在三尖瓣环及右心房游离壁部位各有一折返环。对20例临床上有房扑病史者行射频消融治疗，17例成功。典型房扑15例（包括1例有2个折返环的房扑），14例消融成功；不典型房扑6例，4例消融成功。结论 房扑的大折返环可采用心房激动顺序及隐匿拖带的方法确定其部位。用长导引鞘作支撑行线性消融是治疗房扑的安全有效的方法。
【关键词】 心房扑动 导管消融术 电生理学
Electrophysiological characteristics and radiofrequency catheter ablation of atrial flutter Sun Yingxian, Chan Huibin, Zeng Dingyin, et al. Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang 110001
【Abstract】 Objective This study was to analyse the electrophysiological characteristics of atrial flutter (AF) and evaluate the result of linear radiofrequency (RF) ablation treating atrial flutter. Methods The AF reentrant circuits were mapped by atrial activation sequence and cancelled entrainment. AF was treated by linear RF ablation using long introducer. Results 23 AF circuits of 26 cases were found in the atrium of tricuspid anulus (TA), one in the left atrium, one in the free wall of right atrium and the other was found both in the TA and free wall of right atrium. Twenty cases were treated with RF ablation and 14 of 15 typical AF and 4 of 6 atypical AF were successfully ablated (including one case having 2 reentrant circuits). Conclusion AF reentrant circuits can be found by atrial activation sequence and cancelled entrainment. Linear RF ablation using long introducer is an effective and safe way in treating AF.
【Key words】 atrial flutter catheter ablation electrophysiology
近年来，随着心内电生理学的进展，尤其是射频消融技术的应用，对心房扑动（简称房扑）有了更深入的认识［1～3］。房扑是激动在心房大折返环内运行而引起的心动过速，绝大多数房扑的折返环位于三尖瓣环心房部位，可采用射频消融术治疗［2～7］。现将我们做电生理检查及射频消融术中所遇房扑的病例总结报告如下。
资料与方法
⒈临床资料：1995年10月至1998年3月行心内电生理检查证实为房扑的患者，共26例。男17例，女9例，年龄16～66岁，平均52岁。心动过速病史2个月至30年，3例有晕厥史。本组有器质性心脏病6例，其中[1] [2] 下一页
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