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目的报道一组起源于三尖瓣环(TA)游离壁房性心律失常的心电生理特征及射频消融治疗。方法7例患者经心内电生理检查和射频消融证实的起源于三尖瓣环游离壁的房性心律失常,对其心电生理特点及射频消融进行分析。结果三尖瓣环房速表现为阵发性,为心房程序刺激诱发(4例)或静滴异丙肾上腺素后自发(3例)。三尖瓣环房速有独特的体表心电图特征,所有患者I,aVL导联P波直立,TA11点起源房速II,III,aVF导联P波直立;TA9点起源房速II,III,aVF导联P波低幅直立;TA7点起源房速II,III,aVF导联P波倒置。TA11点起源房速胸导V1导为负向,V2～V6导P波逐渐移行为正向。其余部位TA房速V1～V6P波均为负向。7例患者均消融成功,随访12月均无房速复发。结论三尖瓣环房速有独特的心电图特征和房内激动顺序,长期随访这类房速射频消融有较好的治疗效果。
Objective To report a group of electrophysiological characteristics and radiofrequency ablation of atrial arrhythmias originating from the free wall of the tricuspid annulus (TA). Methods Seven patients with atrial arrhythmias originating from the free wall of the tricuspid annulus were examined by electrophysiological examination and radiofrequency ablation. Their electrophysiological characteristics and radiofrequency ablation were analyzed. Results The tricuspid annulus velocity was paroxysmal and was induced by atrial stimulation (4 cases) or intravenous isoproterenol (3 cases). Atrial tricuspid annulus velocity has a unique surface ECG characteristics, all patients I, aVL lead P wave upright, TA11 point of origin of atrial tachycardia II, III, aVF lead P wave erection; TA9 point of origin of atrial tachycardia II, III, aVF lead P wave low erection; TA7 origin atrial fibrillation II, III, aVF lead P wave inversion. The origin of TA11 point atrial vault lead V1 guide negative direction, V2 ~ V6 P waves guided wave gradually shifted to the positive. The rest of the TA room speed V1 ~ V6P wave are negative. All 7 patients were successfully ablated, and there was no recurrence of RV at follow-up. Conclusion The tricuspid annulus velocity has unique ECG features and in-vivo inflammatory sequence. Long-term follow-up of such atrial tachycardia radiofrequency ablation has a good therapeutic effect.