当右捆分支块在鼻节奏期间出现时,流出管室心律失常的QRS形态是否会发生变化?
Satoshi Hara1, Naoyuki Miwa1, Shigeki Kusa1
1Cardiovascular Center, Tsuchiura Kyodo Hospital, Tsuchiura, Ibaraki, Japan.
Pacing and clinical electrophysiology : PACE
|August 20, 2024
概括
导管操纵可以在心室心律失常 (VA) 切除过程中诱导右束分支阻塞 (RBBB),改变QRS形态. 这种变化并不总是表明VA的转变.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械技术 医疗器械技术
背景情况:
- 心室节律失常 (VAs) 可能表现出由于捆绑分支块 (BBB) 的QRS形态变化.
- 在电生理学过程中,在His捆区域附近的导管操纵可以诱导右捆分支阻塞 (RBBB).
研究的目的:
- 在诱导右束分支阻断 (RBBB) 时,在流出通道 (OT) VA切除过程中调查QRS形态的变化.
- 为了确定诱导的RBBB是否会影响VA起源或切除部位的解释.
主要方法:
- 对195名患者进行回顾性分析,这些患者在外流通道中接受了初始VA切除术.
- 纳入标准:在无线电频率应用之前,在鼻腔节律期间成功地用诱导的RBBB进行OT-VA切除.
- 在带有和没有诱导RBBB的VA中分析QRS形态.
主要成果:
- 在手术过程中,有24名患者 (12%) 患上了RBBB.
- 在5%的诱导RBBB的病例中观察到QRS形态变化.
- 成功的切除部位各不相同,包括右心室外流通道,肺动脉和冠状动脉尖端.
结论:
- 在OT-VA剥离过程中诱导的RBBB可以改变QRS形态.
- 在切除过程中QRS形态的变化并不一定表明VA的起源或出口部位的变化.
- 意识到导管诱导的RBBB对于在VA切除过程中准确解释至关重要.
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