您的位置:山东大学 -> 科技期刊社 -> 《山东大学学报(医学版)》

山东大学学报(医学版) ›› 2012, Vol. 50 ›› Issue (7): 92-96.

• 临床医学 • 上一篇    下一篇

主动脉窦造影及局部电生理特点的临床应用

胡科,陈良华,宋尚明,刘同宝   

  1. 山东大学附属省立医院心内科, 济南 250021
  • 收稿日期:2011-12-30 出版日期:2012-07-10 发布日期:2012-07-10
  • 通讯作者: 刘同宝(1956- ),男,主任医师,教授,主要从事冠心病、心律失常等介入诊疗的研究。 E-mail:liutongbao@medmail.com.cn
  • 作者简介:胡科(1983- ),男, 硕士研究生,主要从事冠心病、心律失常等介入诊疗的研究。 E-mail:sdmedhu@163.com

Clinical application of aortography and local electrophysiological characteristics at the aortic sinus cusps

HU Ke, CHEN Liang-hua, SONG Shang-ming, LIU Tong-bao   

  1. Department of Cardiology, Provincial Hospital Affiliated to Shandong University, Jinan 250021, China
  • Received:2011-12-30 Online:2012-07-10 Published:2012-07-10

摘要:

目的   探讨主动脉窦造影特征和局部电生理特点的临床应用。方法   选取因快速性心律失常而行射频导管消融(RFCA)治疗患者40例,标测导管经逆行主动脉途径测量窦性心律下3个主动脉窦的心房电位(A)和心室电位(V)的振幅,计算心房和心室电位的振幅比率(A/V)。结合主动脉造影的X线影像,分析各主动脉窦的相对位置关系。结果   所有患者左冠窦(LCC)和右冠窦(RCC)心房电位振幅均小于心室, LCC的A/V(0.41±0.15)和RCC的A/V(0.10±0.07)均<1.0。而无冠窦(NCC)心房电位振幅均大于心室,A/V>1.0(5.13±2.56),明显大于另外两个主动脉窦的A/V值(P<0.0001)。LAO45°和RAO30°主动脉造影图像显示RCC位于右前方,LCC位于左上方,NCC位于下后方。结论   在射频导管消融过程中,主动脉窦X线影像和局部电生理特点对消融靶点的寻找具有定位作用,使主动脉窦内的消融更准确、安全和有效。

关键词: 射频导管消融;主动脉窦;主动脉造影;室性心律失常

Abstract:

Objective  To discuss the clinical application of aortography and the local electrophysiological characteristics at the aortic sinus cusps. Methods   In 40 tachycardia patients undergoing radiofrequency catheter ablation(RFCA), the amplitudes of the atrial(A) and ventricular(V) potentials during sinus rhythm were measured at the coronary cusps through aortic retrograde approach, and the amplitude ratio of atrial/ventricular (A/V) potential was also measured. Relative positions of the coronary cusps were analyzed with the aortographic images. Results   For all patients, the amplitudes of the atrial potential were smaller than those of the ventricular potential in the left coronary cusp (LCC)and the right coronary cusp (RCC), and the A/V ratio of LCC(0.41±0.15) and RCC(0.10±0.07) were both <1.0. The amplitude of the atrial potential was larger than the ventricular potential in the noncoronary cusp(NCC), resulting in the A/V ratio >1(5.13±2.56). The A/V ratio of NCC was significantly greater than those of the other two aortic sinus cusps (P<0.0001).The aortographic images in the LAO 45°and RAO30°projections showed the RCC was located in the right front direction, the LCC in the left top direction, and the NCC in the inferior and posterior direction. Conclusion   In the process of RFCA, the aortographic images and the local electrophysiological characteristics have the function of mapping the suitable targets at the aortic sinus cusps, and thus make it more accurate, safer and more effective.

Key words: Radiofrequency catheter ablation; Aortic sinus cusps; Aortography; Ventricular tachycardia

中图分类号: 

  • R541.7
[1] 郑少华1,张玉娇1,李志远2,侯绪娟3,王曦敏1,段文昌4,侯应龙1. 持续性快速右心房起搏犬肺静脉-左心房连接处自主神经重构的研究[J]. 山东大学学报(医学版), 2013, 51(12): 7-10.
[2] 付开丽1,张学义2,朱萌3,王志浩1,王华1,钟明1,张运1,张薇1. 不同病因心房颤动患者卒中危险的评估[J]. 山东大学学报(医学版), 2013, 51(06): 61-63.
[3] 孙雪林1,2,卜培莉1,刘军妮1,曹广庆3,李丽4,于琼4. 心房颤动患者心房组织SIRT1表达与心房纤维化的相关性[J]. 山东大学学报(医学版), 2012, 50(9): 68-72.
[4] 王卫杰,张玉娇,高梅,王奖荣,侯应龙. 瑞舒伐他汀对心肌梗死兔心房结构重构的影响[J]. 山东大学学报(医学版), 2012, 50(4): 29-32.
[5] 魏子秀,张梅. 阿托伐他汀联合胺碘酮对双腔起搏患者心房颤动发生率的影响[J]. 山东大学学报(医学版), 2011, 49(2): 93-96.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!