冠状窦内导管消融左心房房性心动过速的评价(摘要)
作者：马长生 颜红兵 王勇 周玉杰 赵霞 赵桂茹 李淑梅(第三作者)
单位：北京市，中日友好医院 心内科(100029) 马长生 颜红兵 王 勇 周玉杰 赵 霞 赵桂茹；白求恩医科大学第二附属医院 李淑梅(第三作者)
关键词：
目的 目的：报告导管消融证实病灶位于冠状窦(CS)内的2例房性心动过速。
方法：两例均为年轻男性，无器质性心脏病。常规电生理检查证实为左心房房性心动过速(房速)。经心房间隔将消融导管送入左心房。采用激动顺序标测法标测。
结果：例1在二尖瓣环房侧标测到A波较CS近端电位提前6～7 ms。以10～30 W功率消融5次均不能终止房速。两次移动CS电极导管时房速均暂时终止，提示异位灶位于CS内。遂将消融导管送入CS内。在距冠状窦口3.0 cm处标测到最早A波较CS近端电极A波提前10 ms。以7 W输出功率放电1.5 s时房速终止，继续放电40 s后以10 W巩固放电160 s。采用各种心房刺激均不能诱发房速。随访20个月，房速无复发。例2在二尖瓣环房侧标测到A波较CS近端电位提前5 ms。以10～20 W功率消融4次均不能终止房速。将消融导管送至CS内，在距冠状窦口4.5 cm处标测到最早A波较CS近端电极电位提前11 ms。以10 W输出功率放电即刻房速终止，巩固放电60 s。采用各种心房刺激均不能诱发房速。随访8个月，房速无复发。
, 百拇医药
结论：在二尖瓣环房侧标测和消融房速不成功时，应考虑行CS内标测和消融。CS内低动率消融安全、有效。
Catheter Ablation of Left Atrial Tachycardias in Coronary Sinus(Abstract)
Department of Cardiology, China-Japan Friendship Hospital, Beijing (100029)
Ma Changsheng, Yan Hongbing, Li Shumei, et al.
Objective: We here describe our initial experience in two cases of atrial tachycardia (AT) originating from the coronary sinus (CS), which was confirmed by a successful catheter ablation.
, http://www.100md.com
Methods: Both were young males without any evidence of organic heart disease. A diagnosis of left AT was established in a routine electrophysiological study. An ablation catheter was transseptally put into the left atrium. Local atrial activation mapping technique was used during AT.
Results: In Case 1, local atrial activation during AT occurred 6～7 ms before the onset of the CS proximal potential at the atrial aspect of the mitral annulus, and AT did not terminate after five-times radiofrenency energy delivery with an output power of 10～30 W. A corsequent twice movement of the mapping catheter in the CS resulted in a termination of AT, suggesting an ectopic origin of AT in the CS in which the ablative catheter was put. Local atrial activation during AT occurred 10 ms before the onset of the CS proximal potential. AT terminated after 1.5 s energy delivery with an output power of 7 W was used with a continuous delivery for 40 s. And the output power was increased to 10 W for another 160 s. Various atrial stimulation techniques failed to induce AT. AT had no recurrence with a 20-months follow-up. In Case 2, local atrial activation during AT occurred 5 ms before the onset of the CS proximal potential, and four-times energy delivery with an output power of 10～20 W did not terminate AT. An ablation catheter was cathelerized into the CS. Local atrial activation during AT occurred 11 ms before the onset of the CS proximal potential at 4.5 cm far from the ostium of the CS. AT terminated immediately after an energy delivery with an output power of 10 W was used with a contineus delivery for another 60 s. AT did not be induced by using various atrial stimulation techniques. No recurrence occurred with a 8-months follow-up.
Conclusions: Local activation mapping and ablative therapy in the CS was recommended when they failed to be carried out at the atrial aspect of the mitral annulus. And an ablation procedure in a low output power was a safe and effective modality., http://www.100md.com
单位：北京市，中日友好医院 心内科(100029) 马长生 颜红兵 王 勇 周玉杰 赵 霞 赵桂茹；白求恩医科大学第二附属医院 李淑梅(第三作者)
关键词：
目的 目的：报告导管消融证实病灶位于冠状窦(CS)内的2例房性心动过速。
方法：两例均为年轻男性，无器质性心脏病。常规电生理检查证实为左心房房性心动过速(房速)。经心房间隔将消融导管送入左心房。采用激动顺序标测法标测。
结果：例1在二尖瓣环房侧标测到A波较CS近端电位提前6～7 ms。以10～30 W功率消融5次均不能终止房速。两次移动CS电极导管时房速均暂时终止，提示异位灶位于CS内。遂将消融导管送入CS内。在距冠状窦口3.0 cm处标测到最早A波较CS近端电极A波提前10 ms。以7 W输出功率放电1.5 s时房速终止，继续放电40 s后以10 W巩固放电160 s。采用各种心房刺激均不能诱发房速。随访20个月，房速无复发。例2在二尖瓣环房侧标测到A波较CS近端电位提前5 ms。以10～20 W功率消融4次均不能终止房速。将消融导管送至CS内，在距冠状窦口4.5 cm处标测到最早A波较CS近端电极电位提前11 ms。以10 W输出功率放电即刻房速终止，巩固放电60 s。采用各种心房刺激均不能诱发房速。随访8个月，房速无复发。
, 百拇医药
结论：在二尖瓣环房侧标测和消融房速不成功时，应考虑行CS内标测和消融。CS内低动率消融安全、有效。
Catheter Ablation of Left Atrial Tachycardias in Coronary Sinus(Abstract)
Department of Cardiology, China-Japan Friendship Hospital, Beijing (100029)
Ma Changsheng, Yan Hongbing, Li Shumei, et al.
Objective: We here describe our initial experience in two cases of atrial tachycardia (AT) originating from the coronary sinus (CS), which was confirmed by a successful catheter ablation.
, http://www.100md.com
Methods: Both were young males without any evidence of organic heart disease. A diagnosis of left AT was established in a routine electrophysiological study. An ablation catheter was transseptally put into the left atrium. Local atrial activation mapping technique was used during AT.
Results: In Case 1, local atrial activation during AT occurred 6～7 ms before the onset of the CS proximal potential at the atrial aspect of the mitral annulus, and AT did not terminate after five-times radiofrenency energy delivery with an output power of 10～30 W. A corsequent twice movement of the mapping catheter in the CS resulted in a termination of AT, suggesting an ectopic origin of AT in the CS in which the ablative catheter was put. Local atrial activation during AT occurred 10 ms before the onset of the CS proximal potential. AT terminated after 1.5 s energy delivery with an output power of 7 W was used with a continuous delivery for 40 s. And the output power was increased to 10 W for another 160 s. Various atrial stimulation techniques failed to induce AT. AT had no recurrence with a 20-months follow-up. In Case 2, local atrial activation during AT occurred 5 ms before the onset of the CS proximal potential, and four-times energy delivery with an output power of 10～20 W did not terminate AT. An ablation catheter was cathelerized into the CS. Local atrial activation during AT occurred 11 ms before the onset of the CS proximal potential at 4.5 cm far from the ostium of the CS. AT terminated immediately after an energy delivery with an output power of 10 W was used with a contineus delivery for another 60 s. AT did not be induced by using various atrial stimulation techniques. No recurrence occurred with a 8-months follow-up.
Conclusions: Local activation mapping and ablative therapy in the CS was recommended when they failed to be carried out at the atrial aspect of the mitral annulus. And an ablation procedure in a low output power was a safe and effective modality., http://www.100md.com