论文部分内容阅读
目的:探讨射频消融对室上性心动过速患者冠状窦激动时间及心房间电传导的影响。方法:室上性心动过速患者38例,其中左侧旁路20例,房室结折返心动过速18例。消融前,分别于高位右心房、低位右心房、冠状窦各电极(CS9,10、CS7,8、CS5,6、CS3,4、CS1,2)以500 ms周长发放连续刺激。消融成功后,重复以上刺激。观察最早激动部位、最晚激动部位、冠状窦电极上的心房激动顺序、冠状窦激动时间(CSo-CSd)。结果:①射频消融可造成经冠状窦传导的延迟及心房间电传导的延迟。左侧旁路组,射频消融前后对比,在低位右心房、CS7,8、CS3,4、CS1,2起搏时,冠状窦激动时间由(34.56±4.63)、(26.56±2.28)、(24.11±4.07)和(35.56±3.22)ms分别延长至(39.56±6.90)、(29.78±5.59)、(27.56±3.11)和(39.78±3.66)ms,均有显著差异(P<0.05)。②低位右心房起搏是观察冠状窦及心房间电传导的较佳部位。③冠状窦中段起搏时冠状窦激动时间最短。④心房下部起搏时冠状窦是优势传导通路。结论:在低位外侧右心房起搏下,左侧旁路消融造成冠状窦激动时间延长。
Objective: To investigate the effect of radiofrequency catheter ablation on coronary sinus activation time and atrial electrical conduction in patients with supraventricular tachycardia. Methods: 38 patients with supraventricular tachycardia, including 20 cases of left bypass, atrioventricular nodal reentrant tachycardia in 18 cases. Prior to ablation, continuous stimulation was delivered at 500 ms perimeter in the upper right atrium, lower right atrium, and coronary sinus electrodes (CS9,10, CS7,8, CS5,6, CS3,4, CS1,2). After successful ablation, repeat the above stimulation. The earliest excitatory site, the latest site of excitement, the atrial activation sequence at the coronary sinus electrode, and the coronary sinus activation time (CSo-CSd) were observed. Results: (1) Radiofrequency ablation can cause the delay of conduction through the coronary sinus and the delay of atrial electrical conduction. In the left bypass group, before and after radiofrequency ablation, the time of coronary sinus activation was (34.56 ± 4.63), (26.56 ± 2.28) and (24.11) in the lower right atrium, CS7,8, CS3,4 and CS1,2 ± 4.07 and 35.56 ± 3.22 ms respectively, which were significantly higher than that of the control group (39.56 ± 6.90), (29.78 ± 5.59), (27.56 ± 3.11) and (39.78 ± 3.66) ms, respectively (P <0.05). ② low right atrial pacing is to observe the coronary sinus and atrial electrical conduction better site. ③ Coronal sinus pacing the shortest coronary sinus time. ④ inferior atrial pacing coronary sinus is the dominant conduction pathway. CONCLUSIONS: In the low lateral right atrial pacing, the time of coronary sinus activation prolonged by left bypass ablation.