P波形态改变和消融部位双电位与下腔静脉-三尖瓣环峡部完全性阻滞  

The change of P wave morphology and double potentials at ablation site after complete inferior vena caval-tricuspid annulus isthmus blocked

作　　者：马坚[1] 王方正[1] 余培桢[1] 王锦志[1] 张奎俊[1] 华伟[1] 楚建民[1] 方丕华[1] 孙瑞龙[1] 陈新[1] 

机构地区：[1]中国医学科学院 中国协和医科大学 心血管病研究所 阜外心血管病医院,100037

出　　处：《中华心律失常学杂志》1998年第3期165-168,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的探讨下腔静脉-三尖瓣环峡部(简称峡部)完全性双向阻滞的心电图和电生理表现。方法对18例心房扑动患者的峡部进行线性射频消融,峡部发生完全性阻滞后,起搏刺激冠状静脉窦口和右房下侧壁,观察分析Ⅱ导联 P 波形态和消融部位双电位。结果 18例患者均消融成功并发生峡部完全性双向阻滞,并且Ⅱ导联 P 波呈负正双向;对12例患者标测消融部位,均记录有特征性双电位,其敏感性为100%。结论心电图Ⅱ导联 P 波形态改变和消融部位特征性双电位是判定峡部完全性阻滞的可靠标志。Objective To investigate the electrocardiographic and electrophysiologie manifestations of complete bidirectional block at the inferior vena caval-tricuspid annulus isthmus.Methods A radiofre- quency ablation line was made at isthmus in eighteen patients with atrial flutter.After the isthmus was completely blocked,the P wave morphology in lead Ⅱ and double potentials at ablation site were assessed during pacing at coronary sinus ostium and low lateral right atrium respectively.Results Ablation was successful and complete bidirectional isthmus block was achieved in all of the 18 patients,then negative- positve biphasic P wave pattern was found in lead Ⅱ.Special double potentials were recorded at ablation site in all of 12 patients with careful mapping,the sensitivty was 100%.Conclusion Both the change of P wave morphology and double potentials at ablation site are reliable markers of complete isthmus block.

关 键 词：峡部 阻滞 消融 P波形态 心电图 部位 下腔静脉 三尖瓣 患者 改变 

分 类 号：R541[医药卫生—心血管疾病] R540[医药卫生—内科学]