周 赟, 孙育民, 张 雁, 曹 宾, 黄少华, 陶文其, 王 骏. 导管消融治疗起源于主动脉根部附近室性期前收缩7例[J]. 心脏杂志, 2013, 25(5): 569-572.
    引用本文: 周 赟, 孙育民, 张 雁, 曹 宾, 黄少华, 陶文其, 王 骏. 导管消融治疗起源于主动脉根部附近室性期前收缩7例[J]. 心脏杂志, 2013, 25(5): 569-572.
    Treatment of catheter ablation in seven cases of preventricular contractions originating from the aortic root[J]. Chinese Heart Journal, 2013, 25(5): 569-572.
    Citation: Treatment of catheter ablation in seven cases of preventricular contractions originating from the aortic root[J]. Chinese Heart Journal, 2013, 25(5): 569-572.

    导管消融治疗起源于主动脉根部附近室性期前收缩7例

    Treatment of catheter ablation in seven cases of preventricular contractions originating from the aortic root

    • 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.

       

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