Mahaim纤维的电生理学特征及射频消蚀治疗（附一例报告）  

TheelectrophysiologyandradiofrequencyablationofMahaimfiber

作　　者：王玉堂[1] 单照亮[1] 王思让[1] 阎保国[1] 李天德[1] 黄大显[1] 

机构地区：[1]解放军总医院心内科

出　　处：《中华心血管病杂志》1996年第1期19-23,共5页Chinese Journal of Cardiology

摘　　要：近年对Ｍａｈａｉｍ纤维的组织学特征及合并心律失常的发生机制有了全新的认识。旁路的连接方式主要是位于右房侧壁的“类结样”组织与右束支或三尖瓣环下右心室之间的连接。本文报告国内首例Ｍａｈａｉｍ纤维合并室上性心动过速的射频导管消蚀治疗结果。病人主要特征包括：窦性心律时仅表现为轻微的心室预激，心动过速时心电图呈左束支阻滞图形；高右房快速刺激时１２导联心电图图形几乎与心动过速时完全相同，希氏束电位与Ｖ波融合并呈现逆向传导特征；旁路无逆传功能，前传功能表现出递减传导特性；在三尖瓣环下右室侧壁标测到心室最早激动点和Ｍａｈａｉｍ电位，并在此处成功消蚀旁路传导。本例病人治疗结果提示，Ｍａｈａｉｍ电位的标测对治疗成功具有重要意义。NewconcepthasrecentlybenpresentedabouttheanatomyandthemechanismoftachycardiaofMahaimfiber.Itwasproposedthat“nodelike”structurelocalizedinlateralrightatri-umwalconnectedwithrightbundlebranchorwithlateralrightventricularwal.Morethan40caseshavebeenablatedbyuseofradiofrequencyenergybutnoreportinChinayet.ThispaperpresentsthefirstcaseofMahaimfiberwithtachycardiasucessfulycuredbyradiofrequencyablationinourhospi-tal.Thecharacteristicsinthiscaseincludedslightpreexcitationduringsinusrhythm;leftbundlebranchblocktypeECGduringtachycardiaandrapidatrialstimulation;reversedconductiontypeofHisbundleduringrapidatrialstimulation;noretrogradeconductionviaacessorypathwayduringventricularstimulation;decrementalpropertyviaantegradeacessorypathwayconduction;EVAandMahaimfiberpotentialwasrecordedinrightventricularfrewalundertricuspidvalvularorifice.SucesfulablationwasachievedinthislocationwhichsuggestedthattherecordingofMahaimfiberpotentialwasveryimportantforsuccessfulablation.

关 键 词：MAHAIM纤维 心动过速 电生理 射频消蚀术 

分 类 号：R541.7[医药卫生—心血管疾病]