心腔内单极电图旁道定位和消融靶点的图形特征

采用冠状窦和二尖瓣环单极记录标测左侧显性旁道和确定消融靶点指导射频消融治疗20例预激综合征。同步记录多部位冠状窦单极电图均清楚显示房波(UP)和室波(UR),其旁道定位点表现为 UP 降支和 UR 起始几乎融合构成特征性的复合波——PQS 波,而远离旁道的单极电图显示 UP 和 UR 分离构成 P—QS 或 P—rS 波。二尖瓣环单极记录时其图形变化类同冠状窦。比较冠状窦标测点和二尖瓣环单极电图的图形特征能迅速、直观地确定消融靶点。

Intracardiac Unipolar Electrogram Criteria for Identification of Appropriate Target Sites for Radiofrequency Current Ablation of Accessory Pathways

Twenty patients with Wolff-Parkinson-White syndrome were successfully treated with radiofrequency current ablation(RFCA)under guidance of intracardiac unipolar electrogram recorded from the coronary sinus(UCS)and ventricular aspect of the mitral annulus with ablation catheter(UAb).There were clear atrial(UP)and ventricular(UR)waves in UCSs recorded si- multaneously from multi-sites of coronary sinus.When electrode was localized to the site of acces- sory pathway,the UCS showed the fusion of UP and UR and formed a characteristic complex- PQS wave,and other electrodes far from accessory pathway showed the isoelectrical line between UP and UR and formed another characteristic complexes-P-QS or P-rS waves.The electrograms recorded under mitral annulus also showed the above features.It was very easy to identify the ap- propriate target sites for RFCA from comparing UCS with UAb during simultaneously recording coronary sinus and ventricular aspect of mitral annulus.It was concluded that intracardiac unipolar electrogram was a new and very effective method to guide RFCA.