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|本期目录/Table of Contents|

导管消融治疗起源于主动脉根部附近室性期前收缩7例

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2013年第5期
页码:
569-572
栏目:
临床研究
出版日期:
2013-09-25

文章信息/Info

Title:
Treatment of catheter ablation in seven cases of preventricular contractions originating from the aortic root
作者:
周 赟; 孙育民; 张 雁; 曹 宾; 黄少华; 陶文其; 王 骏
(上海市静安区中心医院心内科，上海 200040)
Author(s):
ZHOU Yun;  SUN Yu min;  ZHANG Yan;  CAO Bin;  HUANG Shao hua;  TAO Wen qi;  WANG Jun
(Department of Cardiology, Central Hospital of Jingan District, Shanghai 200040, China)
关键词:
导管消融; 主动脉根部; 期前收缩; 室性
Keywords:
catheter ablation;  aortic root;  premature ventricular contraction
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的:分析主动脉根部（AR）附近起源的室性期前收缩（室性早搏，室早）心电图特征和导管消融体会。方法： 回顾性分析2010年6月~2012年8月在我院成功行导管射频消融治疗的AR附近起源的7例室早患者资料。结果： 7例室早起源于主动脉窦上3例：右冠状动脉窦（RCC）起源1例，左冠状动脉窦（LCC）1例，LCC与RCC交界处1例；主动脉窦下4例： LCC下近RCC 1例，主动脉瓣与二尖瓣连接处1例，LCC下左小叶三角1例，二尖瓣环12点1例。所有患者靶点腔内激动标测提示双极靶点电图领先体表心电图QRS波起点20～58(34±12) ms，4例（4/7）靶点部位可见室早时局部电位极性逆转。无消融相关并发症发生。 结论： 导管消融AR附近起源室早安全、有效，室早体表心电图可初步判断起源部位，标测和消融时注意局部电位特征。
Abstract:
AIM:To analyze the surface electrocardiogram (ECG) characteristics and treatment of catheter ablation in premature ventricular contractions (PVCs) originating from the aortic root (AR). METHODS: A retrospective analysis was carried out in seven cases of PVCs originating from the AR that had been successfully ablated in our hospital from June 2010 to August 2012. RESULTS: Of the seven cases, three cases originated from above the aortic sinus ［one case in the right coronary sinus cusp (RCC), one case in the left coronary sinus cusp (LCC) and one case located at the LCC and RCC junction］ and four cases from below aortic sinus ［one case below the LCC and RCC junction, one case at aortomitral continuity (AMC), one case at the left triangular lobule below the LCC and one case at 12:00 of the mitral annulus］. The time of the bipolar electrocardiogram leading surface QRS wave at the final target was on average of 20-58(34±12) ms. Local potential polarity reversed in four patients (57%) during PVC attacks. No ablationrelated complications occurred. CONCLUSION: Catheter ablation of PVCs near the AR is safe and effective. Changes of surface ECG and local potentials during mapping may locate the origin of the PVCs.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2013-02-17.通讯作者：王骏，主任医师，主要从事冠心病、心律失常的介入诊治研究 Email：wangjun@medmail.com.cn 作者简介：周赟，主治医师 Email：zhouyun2326@hotmail.com
更新日期/Last Update: 2013-09-30