从持续的左上静脉中产生的心房动
Li-Fern Hsu1, Pierre Jaïs, David Keane
1Hôpital Cardiologique du Haut-Lévèque, Bordeaux-Pessac, France. hsulifern@yahoo.com.sg
Circulation
|February 6, 2004
概括
持续的左上 vena cava (LSVC) 可以启动心房动 (AF). 导管切除以LSVC与心房的连接为目标,在大多数患者中成功隔离了心律失常源,恢复了鼻节律.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏解剖学 心脏解剖学
背景情况:
- 左上 vena cava (LSVC) 是一个与马歇尔带相关的胚胎残留物,这是一个涉及心房动 (AF) 的结构.
- 持续的LSVC很少见,通常与有组织的心律失常有关,但以前没有与AF启动有关.
- 这项研究调查了LSVC作为外皮触发AF的潜在来源.
研究的目的:
- 为了确定左上 vena cava (LSVC) 作为外阴的源头,启动心房动 (AF).
- 调查LSVC,冠状动脉鼻 (CS) 和左心房 (LA) 之间的解剖学和电气连接.
- 为了评估导管切除的有效性,针对这些LSVC连接来治疗抗药性AF.
主要方法:
- 5名患有症状,抗药性AF的患者的病例系列.
- 电解剖学绘图和多电极记录以识别来自LSVC的异位.
- 评估LSVC,CS和LA之间的电气连接.
- 导管切除向确定了LSVC连接.
主要成果:
- 在5名肺静脉隔离后的患者中,来自LSVC的ectopy被确定为AF的来源.
- 患者在LSVC,CS和LA之间表现出不同程度的电气连接.
- 在5名患者中有4名患者中,导管切除成功实现了LSVC的电隔离.
- 在15个月的随访期间,在4名患者中,成功的切除导致了持续的鼻节律,而无需服用抗不律性药物.
结论:
- 持续的左上 vena cava (LSVC) 可以作为一个心律失常的焦点来启动心房动 (AF).
- 在LSVC,冠状动脉鼻和左心室之间的特定电气连接促进AF生成.
- 针对这些LSVC连接的导管切除是实现电隔离和治疗AF的有效策略.
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