主动脉无冠窦径路在房室结周房性心动过速消融治疗中的作用

摘要

目的 探讨主动脉无冠窦(NCC)径路在房室结周房性心动过速(简称房速)消融治疗中的作用.方法 共113例进行过电生理检查和射频消融的局灶性房速患者入选本研究.对需在NCC消融的患者以及其他房室结周房速患者的电生理特性和靶点记录图进行比较.结果 在113例局灶性房速患者中,有20例患者起源于房室结周.其中,仅5例(25％)患者需在NCC消融,其余患者均能在右房前间隔消融成功.两类房速在激动模式、右房最早激动点的三维标测特点、房室结周消融终止房速发作所需时间上均无差别.结论 大约1/4的房室结周房速需至NCC消融,然而,尚未发现能预测房室结周房速起源位点的临床和电生理线索.%Objective To characterize the role of non-coronary cusp(NCC) ablation in the treatment of perinodal atrial tachycardias (ATs) among a cohort of patients with perinodal ATs.Methods A total of one hundred and thirteen patients with focal ATs who underwent electrophysiologic study and radiofrequency catheter ablation were enrolled in the study.The electrophysiological characteristics and the target electrograms of those who need NCC ablation and other patients of perinodal ATs were compared.Results Totally 20 cases were revealed to have the focal ATs located in the perinodal area.Among them,only five cases (25 ％)warranted ablation in the NCC,whereas the remainder could be successfully eliminated by ablation from the endocardial right atrium at the perinodal region.There were no clinical and electrophysiological clues observed to have the potential to predict the true original site,including the activation mode,the three dimensional mapping characteristics of earliest activation site in the right atrium,as well as the time of termination during the ablation in the perinodal area.Conclusions Approximately one fourth of the perinodal ATs need ablation in the NCC.However,no clinical and electrophysiological clues could predict the true origin site of the perinodal ATs.