摘要
目的 研究起源于Koch氏三角房性心动过速 (房速 )的电生理特征和射频导管消融的可行性。方法 对 14例起源于Koch氏三角的房速患者进行了电生理和射频消融研究 ,其中女 8例 ,男 6例 ,年龄 13～ 71(4 7± 2 0 )岁 ,平均心动过速病史 (13± 12 )年。结果 12例射频导管消融成功 ,其中房速起源点位于Koch氏三角尖部即希氏束附近 4例 ,位于底部冠状窦口附近 8例 ;2例消融未成功者 ,房速起源点均位于希氏束附近。 9例房速可被右房程序电刺激诱发和终止。 5例需要异丙肾上腺素诱发。发作时的体表 12导联的心电图P′波特征 :Ⅰ、aVL导联均为正向 ,下壁导联几乎都为负向。无 1例发生房室传导阻滞或手术相关的并发症。结论 射频消融治疗起源于Koch氏三角的房速是可行的。
Objective To study the electrophysiologic characteristics and the feasibility of radiofrequency catheter ablation of atrial tachycardia originating from Koch's triangle. Methods Fourteen patients [8 females, 6 males, mean age (47±20) years ] with atrial tachycardia within the triangle of Koch underwent electrophysiologic study and radiofrequency catheter ablation procedures. The mean history of tachycardia was (13±12)years. Results The atrial tachycardia was ablated successfully in 12 patients, of which 4 cases with focus at the apex of Koch's triangle (near the His bundle) and 8 cases at the base (near theos of coronary sinus ).Two patients with atrial tachycardia focus near the His bundle were unsuccessful. The ablation in the atrial tachycardia in 9 patients was induced and terminated by right atrial programmatic stimuli. Isoproterenol was required for induction in the other 5 patients. The characteristics of surface ECG during the tachycardia attack was that P wave was upright in leads I, aVL and almost inverted in inferior leads. No AV block and ablation-related complications occurred. Conclusion Radiofrequency catheter ablation is feasible for atrial tachycardia originating from the triangle of Koch.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2002年第4期218-220,共3页
Chinese Journal of Cardiology
