不纯心房扑动发生机制的心内电生理探讨

目的：心内电生理检查研究体表心电图不纯心房扑动的可能发生机制。方法6例患者经体表心电图证实有不纯心房扑动，射频消融时进行了心内电生理检查，并进行峡部阻断法消融心房扑动。结果：体表心电图与心心内电图同步记录证实，6例不纯心房扑动发作时均为右心房扑动、左心房颤动的心房脱节，心房扑动射频消融均获成功。随访期中2例复发，再次消融成功。结论：不纯心房扑动的发生可能是在右心房扑动的同时，左心房发生一过性颤动的结果。

Intracardiac electrophysiological study of mechanism of impure atrial flutter

Objective To study possible mechanism of impure atrial flutter (AFL) recognized on surface electrocardiogragm (ECG) by intracardiac electrophysiological examinations. Methods Six patients with impure AFL recognized in surface ECG underwent intracardiac electrophysiological examination when radiofrequency catheter ablation (RFCA) were being performed. After that we cured AFL by RFCA isthmus block. Results Simultaneous recordings of surface ECG and intracardiac electrogram(EGM) confirmed that there was atrial dissociation in which AFL was prewsent in right atrium and atria fibrillation in left atrium, when impure AFL occurred in these 6 patients. AFL was ablated successfully in all six patients, but 2 patients recurred later, and reablated successfully. Conclusion Impure atrial flutter in these patients may be results of transient atrial fibrillation in left atrium while right atrium rhythm is still flutter.