论文部分内容阅读
目的探讨欧氏瓣对Ⅰ型心房扑动(简称房扑)导管射频消融即刻效果的影响。方法28例老年Ⅰ型房扑患者(呈逆钟向折返18例,顺钟向折返10例)在透视解剖标志和Halo电极三尖瓣环标测电图指引下,在房扑发作或冠状窦口起搏时以温控方式消融位于三尖瓣口和下腔静脉口之间的后峡部,消融方向从三尖瓣叶右室侧到下腔静脉开口。预设温度70℃,每点消融30s,每次移动消融电极3～5mm。观察下列指标:①房扑终止和后峡部阻滞时消融电极在消融线上所处的位置;②房扑终止后峡部残存传导间隙在消融线上所处的位置;③房扑终止后继续消融致后峡部完全阻滞的最终消融部位。结果根据右前斜位30°透视影像测得后峡部平均弧长(即消融线)为38.6±9.7mm。28例全部达到后峡部完全阻滞的消融终点,无并发症。与欧氏瓣有关的房扑终止率为100%(17/17),与欧氏瓣有关的后峡部完全阻滞发生率为92.9%(26/28)。结论欧氏瓣是Ⅰ型房扑后峡部消融线终点的重要标志,线性消融时欧氏瓣心室侧易残存传导间隙,消融该部位的残存传导间隙是Ⅰ型房扑后峡部消融的重要环节。
Objective To investigate the effect of Euclidean flaps on the immediate effect of radiofrequency catheter ablation of type Ⅰ atrial flutter. Methods Twenty-eight elderly patients with type Ⅰ atrial flutter were retrospectively analyzed retrospectively and retrospectively. Twenty-eight patients with type Ⅰ atrial flutter were retrospectively analyzed retrospectively and retrospectively. Ten patients undergoing atrial flutter or coronary sinus During oral pacing, the posterior isthmus located between the tricuspid valve mouth and the inferior vena cava mouth is ablated by temperature control. The ablation direction is from the right ventricular side of the tricuspid valve to the inferior vena cava. Preset temperature 70 ℃, each point ablation 30s, each move the ablation electrode 3 ~ 5mm. The following indicators were observed: ① The location of the ablation electrode on the ablation line when the atrial flutter was terminated and the posterior isthmus was blocked; ② The location of the isthmus residual conduction gap on the ablation line after the termination of the atrial flutter; ③ The ablation continued after ablation After the complete block of the isthmus ablation site. Results According to the right anterior oblique 30 ° fluoroscopic image measured after isthmus arc length (ie ablation line) was 38.6 ± 9.7mm. All 28 cases reached complete posterior isthmus ablation termination point, no complications. The rate of complete closure of the posterior isthmus associated with the echovirus was 92.9% (26/28) with 100% (17/17) termination of the ectoparaspinal flap. Conclusion The Euclidean flap is an important sign of the end point of the isthmus ablation line in type Ⅰ atrial flutter. The ectocervix flaps tend to remain in the ventricular space during ablation. The residual conduction gap in this site is an important link in the isthmus ablation.