李莹 周聊生 娄兹谟 阎素华 陈明友 山东省千佛山医院心内科 山东济南 250014 中国心脏起搏与心电生理杂志 2000 0 14 3


    关键词：心动过速，房室结折返性；导管消融，射频电流；导管标测；延迟电位 期刊 zgxzqbyxdslzz 0 147-150 房室结的电生理特性专栏 fur -->


    

摘要 为了探讨A波延迟电位在慢径消融靶点定位中的应用价值，对传统下位法和A波延迟电位引导下的慢径消融两组病例的靶点的电生理特征进行了研究。结果：延迟电位引导下的慢径消融在提高成功率、减少试放电方面明显优于下位法。有效靶点的突出特征是A波宽度>68 ms、A波终末具延迟电位，A/V比例不能作为预测靶点的指标。A波延迟电位有四种形态，分别为单弓状延迟电位、双弓状延迟电位、穗状电位及A波终末的高频电位，其中以前两种最为常见。当程序刺激遇快径不应期而经慢径传导时，靶点正传的A波更加延迟，逆传A波更加领先是成功靶点的特征。结论：在慢径消融的靶点定位中应用A波延迟电位和程序刺激可提高成功率、减少盲目性，A波延迟电位引导慢径消融方法优于传统的消融方法。

    中图分类号 R454.1 R541.7⁺ 1 文献标识码 A

    文章编号 1007—2659(2000)03—0147—04

The Significance of A-Wave Delay Potential in Localization of the Target Sites of Slow Pathway Ablation.

LI Ying,ZHOU Liao-sheng,LOU Zi-mo,et al.

To evaluate the A-wave delay potential in ablation of the slow pathway,we comparatively analysed the electrophysiological characteristics of ablation target of two groups.Group A was performed by using traditional inferior anatomic technique and group B performed by A-wave delay potential guided ablation.Result:A-wave delay potential guided radiofrequency catheter ablation was more superior than group A in enhancing the successful rate and decreasing the trying application.The charactristics of the effective target were A-wave duration was more than 68 ms;A-wave followed by delay potential.A/V ratio can't be regarded as the effective parameter.A-wave delay potential has four forms:single-hump shaped potential,double-hump shaped potential,spike shaped potential and high frequency potential.Program electronic stimulation is useful technique for target localization.When activity moves from fast pathway to slow pathway,the antegrade A₂ of effective target was further delay and the retrograde A₂ was more prematrue.Conclution:Using of A-wave delay potential and program electronic stimulation in localization of the target of slow pathway ablation is more effective than traditional technique.

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