环肺静脉消融术中肺静脉电位延迟时间与补点位置间的关系

Relationship between the location of gap ablation with the delay time of pulmonary vein potential in procedure of circumferential pulmonary vein isolation

目的:探讨心房颤动环肺静脉消融术中肺静脉电隔离补充消融位置与肺静脉电位延迟程度之间的关系。方法:57例在三维标测系统指导下导管射频消融治疗的房颤患者,行环同侧肺静脉的线性消融和残余传导补充消融以达肺静脉电隔离。收集两侧环线左右各6个补充消融部位窦性心律下肺静脉电位延迟时间,比较其差别。结果:肺静脉电位延迟时间在右侧补充消融6个部位间无明显差异;左侧补充消融6个部位:左上肺静脉前交叉与后上、前上、前壁之间(P=0.000,0.034,0.004),后上与前上之间(P=0.032),左下肺静脉前壁与左上肺静脉后上、前壁之间差异有统计学意义(P=0.007,0.026)。延迟时间大于150 ms补充消融位置大多在左侧前交叉至左下肺静脉前下壁。结论:测量肺静脉电位延迟程度,可用来快速寻找左侧环肺静脉线残余传导裂隙指导补充消融。

Objective： To evaluate the relationship between the location of gap ablation with the delay time of pulmonary vein potential in procedure of circumferential pulmonary vein ablation in cases with atrial fibrillation.Methods： All of 57 cases with atrial fibrillation who underwent circumferential pulmonary vein ablation and gap ablation by three-dimensional electroanatomic mapping system achieved the endpoint of pulmonary vein isolation.To collect about the six gaps with pulmonary vein potential delay time on both sides of ablation site in sinus rhythm and compare their differences.Results： The pulmonary vein potential delay within 6 areas of gaps in the right side had no significant difference.Six areas of gaps in the left side： comparing the anterior crossover with the superior-posterior wall,the superior-anterior wall,the anterior wall（P=0.000,0.034,0.004）,comparing the superior-posterior wall with the superior-anterior wall in left superior pulmonary vein（P=0.032）,and comparing the anterior wall of left inferior pulmonary vein with the superior-posterior wall and the anterior wall of left superior pulmonary vein,differences were significant（P=0.007,0.026）.The common position located between the anterior crossover with the anterior inferior wall of left inferior pulmonary vein in the left side gap ablation when delay time more than 150 ms.Conclusion： The measurement of pulmonary vein potential delay time can be used to quickly find gaps of the left pulmonary vein conduction and supplementary guide ablation.