阵发性心房颤动患者肺静脉前庭心内膜电位的特点分析  

The characteristics of pulmonary vein antrum potential in patients with paroxysmal atrial fibrillation

作　　者：胡福莉[1] 马长生[2] 董建增[2] 刘兴鹏[2] 齐晓勇[1] 龙德勇[2] 喻荣辉[2] 汤日波[2] 李树仁[1] 李晓梅[3] 

机构地区：[1]河北省人民医院心内科,河北石家庄050051 [2]首都医科大学附属北京安贞医院心内科,北京100029 [3]山东省济南市第四人民医院心内科,山东济南250031

出　　处：《中国心脏起搏与心电生理杂志》2009年第6期492-495,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨阵发性心房颤动(简称房颤)患者肺静脉前庭(PVA)区域心内膜电位的特点。方法在三维电解剖标测系统指导下,结合CT影像融合,对25例阵发性症状性房颤患者进行环肺静脉前庭消融术(CPVA)。术中对PVA部位进行标测,记录并分析PVA电位特点。结果环绕双侧PVA各取100个位点,发现右侧PVA取样点中有42个位点为宽时程(≥50 ms)的双峰电位(DP),41个位点为碎裂电位(CFAE),17个位点为单电位(SP)或窄时程(<50 ms)DP。左侧取样点中38个为DP,48个位点为CFAE,14个位点为SP。双侧PVA区域心内膜电位均以DP或CFAE为主(占84.5%),只有少数区域(15.5%)为SP;环PVA区域不同部位之间电位分布无差异(P>0.05)。结论PVA区域心内膜电位多表现为DP或CFAE,在PVA区域寻找这种缓慢的电传导部位,可能有助于PVA的组织学定位。Objective To explore the characteristics of pulmonary vein antrum （PVA） potentials. Methods Twenty-five patients with drugs refractory, paroxysmal atrial fibrillation （AF） , were underwent circumferential pulmonary vein antrum ablation （CPVA） guided by Carto-Merge. Dense mapping along PVA area was performed and the PVA potentials were analyzed. Results One hundred points circling right and left PVA were gathered and analyzed respectively, which including 42 long-duration（≥50 ms） double potentials （DP）, 41 complex fractionated electrograms （CFAE） potentials, 17 single deflection or short-duration （ 〈 50ms） potentials （SP） along right PVA, and 38 DP potentials,48 CFAE potentials and 14 SP along left PVA. DP or CFAE potentials could be recorded around majority area of bilateral PVA （ DP/CFAE vs. SP was 84.5% vs. 15.5% ）. Conclusion PVA potential generally presents as DP or CFAE, and may indicate the key histological site of slow conduction. Mapping around PVA region to reveal those featured potentials allows correct locali- zation of PVA.

关 键 词：电生理学 心房颤动 导管消融 射频电流 肺静脉前庭 影像融合 心内电图 

分 类 号：R541.75[医药卫生—心血管疾病] R540.45[医药卫生—内科学]