右房后壁双电位标测对判断房性心动过速起源点的参考价值

The diagnostic value of double potential mapping at the posterior right atrium in identification of the origin of atrial tachycardia

目的探讨右房后壁双电位标测对判断房性心动过速(简称房速)是否起源于左房的价值。方法选取19例成功行射频消融治疗的房速患者,房速起源点位于左房12例,位于右房7例,所有病例均在右房后壁记录到双电位。结果左房房速时,双电位的第一个成分振幅均明显低于第二个成分,且窦性心律时,同一部位记录的双电位顺序发生逆转,而右房房速时,第一个成分振幅均明显高于第二个成分,窦性心律时两电位的顺序不改变。结论通过右房后壁双电位标测,能快速而可靠地判断房速是否起源于左房。

Objective To demonstrate the value of analysis of double potential（DP） at the posteromedial right atrium in identification of left atrial origin of atrial tachycardia （AT）. Methods 19 consecutive patients with AT undergoing successful ablation were selected. The AT in 12 of them originated from left atriumand in 7 from right atrium. In all cases, DP was recorded from the electrodes of catheter placed in the posterior wall of right atrium. Results The amplitude of the first potential of DP was lower than that of the second potential for AT foci originating in the left atrium. During sinus beats, the sequence of the two potentials reversed. While AT foci originated in the right atrium, the amplitude of the first potential of DP was higher than that of the second potential, and during sinus beats, the sequence of the two potentials remained unchanged. Conclusion Limited right atrial mapping, focusing on analysis of double potentials recorded at the posterior right atrium can identify left atrial origin of AT reliably and rapidly. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2006,20（5 ） ：404 -406]