摘要
探讨起源于主动脉窦内的反复单形室性心动过速(简称室速)和/或频发室性早搏(简称室早)的心电图特点和射频消融治疗.分析35例该类患者的室速和频发室早的心电图、心内电生理检查和射频消融治疗情况.结果:室性心律失常起源于左冠状动脉窦(简称左冠窦)的30例、无冠状动脉窦3例和主动脉根部左冠窦下2例.左冠窦的心电图特点:Ⅰ和aVL导联为rs、rS或QS波形,Ⅱ、Ⅲ和aVF导联为R波形,胸导联R波移行区在V2或V3导联,V5、V6导联为高振幅R波,无S波;V2导联R高度/S高度比值1.29±0.36.主动脉根部左冠窦下起源的心电图特点:和左冠窦起源室性心律失常的心电图特点基本相同,但V5、V6导联有S波.无冠状动脉窦起源的心电图特点:Ⅰ和aVL导联为Rs或R波形,Ⅱ、Ⅲ和aVF导联为R波形,胸导联R波移行区在V3导联.34例消融成功,手术操作时间65～120 min,X光曝露时间12～30 min.1例出现冠状动脉前降支急性闭塞.随访2～53个月,无复发病例.结论:起源于主动脉窦内的室速和/或频发室早有其独特的心电图表现,射频消融能安全、有效地根治此类心律失常.
We sought to investigate the electrocardiographic （ECG） characteristics and assess the results of radiofrequency catheter ablation （RFCA） of ventricular tachycardia （VT） or ventricular premature contractions （VPCs） originating from the left aortic sinus cusp（ACS）. Twelve-lead ECG analysis, electrophysiologic study and RFCA were performed in 35 normal heart patients with VT or VPCs originating from ACS. Results ： Arrhythmia orignating from left ACS, the surface ECG analysis revealed rs, rS or QS wave on lead Ⅰ and aVL, tall R wave on lead Ⅱ , Ⅲ and aVF, tall R wave on lead V5 and V6 but no S wave on either lead V5 or V6. Precordial R wave transition occurred on lead V1 , V2 or V3. The mean R/S wave amplitude on lead V2 was 1.29 ± 0.36 （ range 0.80 to 2.83 ）. For arrhythmia orignating from under left ACS, the surface ECG have same characterictics but with S wave on lead V5 and V6. The surface ECG analysis revealed Rs or R wave on lead Ⅰ and aVL, tall R wave on lead Ⅱ , Ⅲ and aVF. Precordial R wave transition occurred on lead V3 during arrhythmia orignating from posterior ACS. With activation and pacing mapping, 34 of 35 patients with VT or VPCs were successfully abolished. The procedure time was 65 - 120 min and the fluoroscopic time was 12 - 30 min. The left anterior descending acute occlusion was occurred in one patient. None recurrenced during follow-up. Conclusions： The specific ECG characteristics of VT or VPCs originating from the left ASC are helpful for guiding RFCA. This arrhythmia can be successfully and safely abolished. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2005,19 （ 5 ） ：338 - 340 ]
出处
《中国心脏起搏与心电生理杂志》
2005年第5期338-340,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
电生理学
室性心动过速
室性早搏
主动脉窦
导管消融
射频电流
Electrophysiology Ventricular tachycardia Ventricular premature contractions Aortic sinus cusp Catheter ablation ,radiofrequency current
