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