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目的研究肺静脉间嵴消融在环肺静脉线性隔离术中所起的作用。方法共124例阵发性心房颤动(简称房颤)患者在电解剖标测和CT图像整合技术的指导下行环肺静脉线性消融术。手术的终点为肺静脉隔离。环肺静脉消融线完成后,在原消融线径上寻找可能存在的传导“gap”进行补充消融,如反复消融依然无法达到肺静脉隔离者,根据环状标测电极显示的最早肺静脉电位,在消融环线以内肺静脉口处进行节段性消融以实现肺静脉隔离。结果共41.1%的左侧肺静脉和11.3%的右侧肺静脉需在消融环线以内行节段性消融才达到电学隔离,其中左肺静脉节段隔离部位多见于左侧肺静脉间嵴前部;右侧肺静脉节段隔离部位多见于右侧肺静脉间嵴中后部。结论行环肺静脉线性消融的患者中,一部分需要在肺静脉间嵴处消融以提高肺静脉隔离的成功率。
Objective To study the role of pulmonary vein ridge ablation in circumferential pulmonary vein isolation. Methods A total of 124 patients with paroxysmal atrial fibrillation (AF) underwent linear circumferential pulmonary vein ablation under the guidance of electroanatomic mapping and CT image integration techniques. The end of surgery for pulmonary vein isolation. Circumferential pulmonary vein ablation line is completed, the original ablation diameter to find possible conduction “gap ” for ablation, such as repeated ablation is still unable to reach the pulmonary vein isolation, according to the ring of the first electrode to display the earliest pulmonary venous potential, ablation Segmental ablation of the pulmonary veins at the pulmonary loop to achieve pulmonary vein isolation. RESULTS: A total of 41.1% of the left pulmonary veins and 11.3% of the right pulmonary veins needed to be segmental ablated in the ablation ring to achieve electrical isolation. The isolated left pulmonary vein segment was found in the anterior part of the left pulmonary vein. The right pulmonary vein Segment segmental more common in the right pulmonary vein in the posterior crista. Conclusions Some of the patients with circumferential pulmonary vein ablation need to ablation at the pulmonary vein to improve the success rate of pulmonary vein isolation.