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目的 心外科术后大折返性房性心动过速(MATs)的保护性峡部多数位于舒张期.设置新的兴趣窗(WOI)识别大折返环的舒张传导区(DCZ)指导MATs的消融.方法 所有患者均在EnSite三维标测系统下进行高密度激动标测.MATs发作时根据P波顶点的位置计算WOI.WOI的起点位于折返环的舒张期,并通过激动图上白/紫相接部位识别DCZ.结果 连续纳入心外科术后15例MATs的患者.一共完成了16种MATs[周长(259±56) ms]的标测.通过新的WOI设置识别16种MATs的DCZ[宽度(25.38±12.44) mm]均位于受保护的峡部.DCZ局部的传导速度明显慢于收缩期区域的传导速度[(38.9±13.68)cm/s vs (76.24±15.85)cm/s,P＜0.05].DCZ部位即刻消融成功率为100％.随访(11.5±5)个月,共有2例患者房性心律失常复发.结论 通过新的WOI设置可以在电解剖标测图上根据白/紫相接的部位识别心外科术后MATs患者传导缓慢的DCZ部位.DCZ部位多数位于受保护的峡部,多数显示有碎裂电位.消融DCZ可以有效的终止心动过速.“,”Objective The protective isthmus occurred during diastolic period in most macroreentrant atrial tachycardia (MAT) after heart surgery.We set a novel window of interest (WOI) to identify the diastolic conduction zone (IDZ) of the diastolic period to guide ablation of MAT.Methods The patients underwent high-density mapping using the EnSite NavX system.A novel WOI was calculated by identified the peak of the P wave of MATs,and the onset of the WOI was located in the diastolic interval of the circuit.The DCZ was identified by white/violet interface.Results A total of 16 MATs (mean cycle length 259±56 ms) mapping were completed in 15 consecutive patients after heart surgery.The DCZ (mean width 25.38± 12.44 mm) identified by the new setting of the WOI was located in all protective isthmus of the 16 MATs.Local conduction velocity at the sites of DCZ was significantly slower than the systolic area (38.9 ± 13.68 cm/s vs 76.24 ± 15.85 cm/s,P＜0.05).The acute success rate was 100％ with the DCZ ablation.During the (11.5 ± 5) months follow up,two patients had atrial tachyarrhythmia recurrence.Conclusions The DCZ of the MATs after heart surgery patients can be identified by the white /violet interface using a novel window of interest setting in electroanatomic mapping.Moreover,the DCZ is likely to locate in the protective isthmus,and exhibited with fractionated potentials and slow conduction velocity.Ablation of DCZ can terminate the tachycardias effectively.