调节束起源室性心律失常的研究进展  

Ventricular Arrhythmia Originated from Moderator Band

作　　者：时向民[1] 李健[1] 李世兴 张闯[1] SHI Xiangmin;LI Jian;LI Shixing;ZHANG Chuang(Department of Cardiology,The General Hospital of PLA,Beijing 100048,China)

机构地区：[1]解放军总医院心血管病医学部,北京100048

出　　处：《心血管病学进展》2022年第9期769-773,共5页Advances in Cardiovascular Diseases

基　　金：国防创新课题(20-163-02-ZT-008-007-01)。

摘　　要：调节束是右心室的腔内结构,连接右心室间隔和游离壁的前乳头肌,其内走行有右束支及浦肯野纤维,是心律失常的重要起源部位,也称浦肯野介导心律失常。从单纯室性期前收缩到短联律间期室性期前收缩触发的特发性心室颤动,室性心律失常表现为左束支阻滞型,额面电轴朝向左上,胸前导联R/S移行多大于V导联。射频导管消融可有效治疗室性期前收缩及特发性心室颤动,理想的消融靶点前可标测到浦肯野电位,心腔内超声心动图可显示调节束走行,有利于导管贴靠的稳定性及有效消融。Moderator band(MB) is an important intracavity structure which connects septum and anterior papillary.MB contains right bundle branch and Purkinje fiber, which is an important origin site of arrhythmia, also known as Purkinje-mediated arrhythmia.From simple premature ventricular beat(PVB) to short-coupled PVB-induced idiopathic ventricular fibrillation, MB originated ventricular arrhythmias manifest as left bundle branch block with left superior axis and R/S transition greater than lead V,which could be effectively eliminated by radiofrequency catheter ablation.Purkinje potentials could be mapped in the ideal target and intracardiac echocardiography can show the course of the regulating beam, which is conducive to the stability of the catheter and effective ablation.

关 键 词：调节束 浦肯野介导心律失常 室性期前收缩 特发性心室颤动 

分 类 号：R541.7[医药卫生—心血管疾病]