流出道室性早搏起源处异常电位的分布和意义

目的分析流出道室性早搏(简称室早)消融靶点处峰电位的分布及与成功消融靶点间的关系,并对其产生的机制作一初探。方法选取经导管射频消融成功的流出道室早连续病例54例,对其成功靶点处记录到的峰电位的比率和形态进行分析。将峰电位分为4型。Ⅰ型:窦性心律(简称窦律)时有峰电位,而室早时没有。Ⅱ型:窦律时有,室早时也有;室早时峰电位发生反转提前者,为Ⅱa型,未发生反转提前者,为Ⅱb型。Ⅲ型:窦律时无峰电位,室早时也无峰电位。Ⅳ型:窦律时无,而室早时有峰电位。结果室早时在最终成功靶点局部电位上记录到峰电位的共46例,占85.2%,未记录到峰电位的仅8例,占14.8%,其中Ⅰ型2例,Ⅱa型21例,Ⅱb型12例,Ⅲ型6例,Ⅳ型13例。消融靶点位于右室流出道44例,左室流出道10例,而峰电位的分布在左、右室流出道间及右室流出道各部位间没有明显差异。复发4例,其中3例进行了第二次消融,1例第一次为Ⅰ型,第二次为Ⅱa型,2例第一次为Ⅱb型,第二次为Ⅱa型。结论在大多数流出道室早消融靶点处均可记录到峰电位,而室早时该峰电位发生反转提前可以成为成功靶点的有力指征。

The incidence and mechanisms of spike potentials in origin regions of outflow tract premature ventricular contraction

Objective To investigate the incidence and mechanisms of spike potential(SP) in premature ventricular contractions(PVCs) originating from outflow tract in structurally normal heart.Methods Fifty-four consecutive cases with symptomatic PVCs originating from ventricular outflow tract who have been successfully performed radiofrequency catheter ablation were investigated.The incidence and patterns of SP recorded at the successful ablation sites were analyzed.The SP was divided into 4 types.The pattern of SP re...