Halo电极远端电位方向逆转作为典型心房扑动消融终点标准的观察

目的探讨一种通过Halo电极远端电位方向发生逆转来判断典型心房扑动(简称房扑)三尖瓣环峡部线性消融成功的方法。方法 20例典型房扑患者接受射频消融治疗,将Halo电极经右股静脉置于三尖瓣环上,从远端电极至近段电极呈顺时针方向。于窦性心律下,行三尖瓣环至下腔静脉之间线性消融,与此同时,于冠状窦口行S1S1500ms起搏。消融过程中,Halo电极标测显示远端电极及近端电极呈双向传导。以Halo电极远端电位方向逆转作为消融成功终点。结果 20例均消融成功,无消融并发症发生。消融后,反复电刺激未诱发房扑。术后随访6个月,未见房扑复发。结论冠状窦口起搏刺激下,Halo电极远端电位方向出现逆转可作为典型房扑三尖瓣环峡部线性消融成功的可靠指标。

The reversal of the potential of Halo catheter distal pole can serve as the end-point of successful ablation for typical atrial flutter

Objective To investigate a method to judge the end-point of the successful ablation for typical atrial flutter （AFL） by the reversal of the potential of the Halo catheter distal pole. Methods Twenty cases of typical AFL were treated by radiofrequency catheter ablation. The Halo catheter was placed along the tricuspid annulus in clockwise direction from the distal to the proximal pole. The linear ablation from the tricuspid annulus to the inferior vena cava was applied during the coronary sinus pacing by S1S1 500ms and the Halo catheter mapping showed the bi-direction conduction along the tricuspid annulus. The end-point of successful ablation was defined as the reversal of the potential of the Halo catheter dis- tal pole. Results All the 20 patients were ablated successfully without complications. The AFL could not be induced by repeated S1 S1 ,S1 S2 stimulation. After 6 months follow-up, no AFL reoccurred. Conclusion The reversal of the potential of the Halo catheter distal pole can serve as the end-point of successful ablation for typical AFL well. Chinese Journal of Cardiac Pacing and Electrophysiology ,2010 ,24 （ 2 ） ：146 - 148 ]