先天性心脏病外科手术后心房内折返性心动过速的心电图与消融靶点  

Electrocardiogram and ablation targets of intra-atrial reentrant tachycardia after congenital heart dis-ease surgery

作　　者：任振芳[1] 楚建民[1] 方丕华[1] 马坚[1] 姚焰[1] 华伟[1] 张澍[1] 

机构地区：[1]中国医学科学院心血管病研究所北京协和医学院阜外心血管病医院心律失常诊治中心,北京100037

出　　处：《中华心律失常学杂志》2007年第4期301-304,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的分析先天陛心脏病外科手术后心房内折返性心动过速（intra-atrial reentrant tachycar-dia，IART）心电图与消融靶点的关系。方法选择2004年1月至2005年12月在我院因先天性心脏病外科手术后LART行射频消融的24例患者，回顾性分析患者的心电图（F波或P’波）与消融靶点的关系。结果24例患者共诱发出28种IART。17种（17／28，60．7％）IART心电图表现为典型锯齿形F波，其中15种（15／17，88．2％）成功消融靶点在下腔静脉和三尖瓣环（IVC-TA）峡部；另外11种（11／28，39．3％）IART临床心电图表现与典型心房扑动不同，表现为P’波，其中7种（7／11，63．6％）IART成功消融靶点在右心房游离壁瘢痕-下腔静脉，其他分别在IVC-TA、界嵴前方、间隔补片和上腔静脉之间、房间隔补片处消融成功。结论不同部位的IART具有一定的心电图特点，根据这些心电图特点，有助于消融靶点的判定。Objective The purpose of this study is to observe the relationship between electrocardiogram and ablation targets of intra-atrial reentrant tachycardia（IART） after congenital heart disease surgery. Methods Twenty-four patients of IART after congenital heart disease surgery received ablation in our hospital from January 2004 to December 2005. IART were ablated by guidance of three-dimensions mapping system （Carto or EnSite 3000）. The relationship between tachycardia electrocardiogram（ F waves or P＇ waves）and the ablation targets were investigated, respectively. Results Twenty-eight kinds of IART were induced in 24 patients. Seventeen（ 17/28,60. 7% ）kinds of IART electrocardiogram showed typical F waves, of which the success- ful ablation targets located between the inferior vena cava-tricuspid annulus （IVC-TA）isthmus inl5 （15/17, 88.2% ） kinds of IART. Another 11 （ 11/28,39.3 % ） kinds of IART electrocardiogram showed P＇ wave, of which the successful ablation targets located on the right free wall scar-IVC isthmusin 7 （7/11,63.6%）kinds of IART. The other IART successful ablation targets located on IVC-TA, crista terminalis, septal patch-superior vena cava, atrial septal patch ,respectively. Conclusion The electrocardiogram could be helpful to the judgment of the ablation targets with IART.

关 键 词：心房内折返性心动过速 先天性心脏病外科手术后 心电图 

分 类 号：R54[医药卫生—心血管疾病] R65[医药卫生—内科学]