同一肺静脉内缓慢性和快速性肺静脉电位共存现象

Mechanism of bradycardia and tachycardia rhythms co-existence in the same pulmonary vein

目的观察心房颤动(简称房颤)导管消融过程中同一肺静脉发生缓慢性和快速性肺静脉电位共存的现象并分析其可能的机制。方法分析5例持续性房颤患者单Lasso电极标测的心内电图,以及记录消融导致肺静脉电位分层和隔离的部位。结果在房颤消融过程中,1例在右下肺静脉内记录到两种不同的肺静脉电位节律,电位分层以及隔离靶点分别为环肺静脉消融线径的右后下壁和右后上壁近房顶处;4例在左上肺静脉内记录到两种不同的肺静脉电位节律,电位分层以及隔离靶点分别为环肺静脉消融线径的左前下壁和左前上壁。结论同一肺静脉发生缓慢性和快速性肺静脉电位共存现象的原因可能系邻近肺静脉间存在电学连接,亦可能与邻近肺静脉远场电位有关。

Objective To investigate the mechanism of two different rhythms co-existing in the same pulmonary vein during catheter ablating for atrial fibrillation. Methods To analyze endocardiac electrocardiogram and the isolation sites of pulmonary vein potentials mapped by a single Lasso in 5 patients with persistent atrial fibrillation. Results Two different rhythms were mapped within right inferior pulmonary veins in 1 patient during ablating procedure, and the disassociation and isolation sites of pulmonary vein potentials were located at inferior and superior of right posterior walls along ablating route. Also, two different potential rhythms were mapped within left superior pulmonary vein in 4 patients, and the disassociation and isolation sites of pulmonary vein potentials were located at inferior and superior of left anterior wall. Conclusions Potential interconnection may exist between adjacent pulmonary veins, and one pulmonary vein could map far field potential of another pulmonary vein.