在有或没有心房节节点回流性心跳的患者中,在鼻节律期间,科赫三角内激活模式
Koichiro Kumagai1, Hideko Toyama2
1Heart Rhythm Center, Fukuoka Sanno Hospital, 3-6-45, Momochihama, Sawara-Ku, Fukuoka, 814-0001, Japan. kumagai@kouhoukai.or.jp.
概括
高密度映射可以在鼻节律期间揭示科赫三角形中的特定激活模式,有助于理解心房节回入性心力衰竭患者和没有心房节患者的双通路生理学.
科学领域:
- 电力生理学 电力生理学
- 心脏病学 心脏病学
- 心脏解剖学 心脏解剖学
背景情况:
- 研究已经可视化了在心房结节回入性心力衰竭 (AVNRT) 患者的鼻节律期间,科赫三角 (KT) 中的缓慢路径.
- 目前尚不清楚缓慢的路径是否在所有个体中始终可视化.
- 这项研究研究了在AVNRT.患者和没有AVNRT.患者的鼻腔节律期间KT内的激活模式.
研究的目的:
- 评估在鼻节奏期间在科赫三角形 (KT) 中的激活模式.
- 为了确定慢路径是否可以在患有和没有心房节回流性心力衰竭 (AVNRT) 的患者中可视化.
主要方法:
- 使用Advisor HD Grid导管进行高密度映射,对10名慢速AVNRT患者和30名没有AVNRT的患者进行了映射.
- 在鼻节律期间,分析了KT内部的激活模式.
主要成果:
- 在80%的AVNRT患者和40%的非AVNRT患者中观察到围绕KT内的阻塞线 (BL) 旋转的激活模式.
- 这种模式与传导跳跃有显著的关联 (85%的跳跃与15%没有跳跃).
- 在导电跳跃期间,建议在导电跳跃过程中进行潜在的缓慢路径延伸,而不是通过映射可视化.
结论:
- 缓慢的途径本身可能不能直接可视化使用高密度映射在鼻节律.
- 然而,在KT中围绕阻断线旋转的激活模式在大多数双通路生理学患者中可观察到,无论AVNRT是否存在.
- 针对这种模式的线性切除是治疗缓慢快速AVNRT的有效方法.
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