摘要
目的阐明递进式消融术治疗持续性心房颤动（房颤）术后复发双环折返性房性心动过速（房速）的电生理特点。方法人选2007年7月至2012年12月持续性房颤递进式消融术后复发房速的19例患者。结果19例患者均通过详细的三维激动标测（〉200个采集点）和在每个折返环内拖带的方法确定了双环折返的机制，其中大折返环和大折返环组成的双环折返13例，大折返环和局部小折返环组成的双环折返6例。大多数病例消融策略采取分别消融两折返环各自的峡部，先将双环折返变为单环折返（由再次拖带结果确定），最后消融单折返环峡部终止房速。结论双环折返性房速并非是持续性房颤递进式消融术后少见的一种心律失常，详细的三维激动标测联合拖带标测是确诊的最佳方案。
Objective To explore the electrophysiologic characteristics of double-loop reentrant atrial tachycardias （ATs） post catheter ablation for persistent atrial fibrillation（AF） using a step-wise approach. Methods Nineteen patients with organized ATs after step-wise ablation for persistent AF were enrolled.Re- suits All the 19 ATs were diagnosed as double-loop reentrant atrial tachycardia using detailed （〉200 collec- ting points） three-dimensional activation mapping and entrainment mapping at each loop.In 13 cases, two mac- ro-reentry circuits rotated simultaneously forming double-loop reentry. In 6 cases, the double-loop reentry in- volved a macroreentrycireuit and asmall local re-entry.Radiofrequency delivery in the isthmus of each circuit re- spectively first transformed the tachycardia into single-loop reentry （ confirmed by reentrainment） and then ter- minated the ATs in most cases. Conclusion Double-loop reentrant atrial tachycardia was not rare after step- wise ablation for persistent AF. Detailed three-dimensional activation mapping combined with entrainment was one of the best way to make accurate diagnosis.
出处
《中华心律失常学杂志》
2013年第3期176-179,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
房性心动过速
导管消融
Atrial fibrillation
Atrial tachycardia
Catheter ablation
