用电极导管标测对Koch三角的X线影像测定在慢径消融中的价值

The value of measurement of Koch's triangle in X-radiation for ablation of slow pathways with cardiac catheter mapping

目的 :测定Koch三角的X线影像学上的大小及在慢径消融中的价值。方法 :2 7例房室结双径路并折返性室上速的患者 ,用冠状静脉窦口及希氏束标记Koch三角的部位 ,分别用左前斜 (LAO) 4 5°及加头位和足位 2 0°,右前斜 (RAO)30°及加用头位和足位 2 0°测量Koch三角的高度 ,以 2 0mm为界将Koch三角分为大小两组。结果 :Koch三角有较差异 ,以LAO45°显示最小 ,RAO +足位显示最大。结论 :小Koch三角组慢径多分布位置低 ,消融时可参考RAO +足位 ;大Koch三角组消融位置多在中下 1/ 3以下区域。

Objective:To measure size of Koch's triangle in the X-radiation and to evaluate the value in ablation of slow pathway.Methods:27 patients with AV nodal reentry tachycardia marked with coronary sinus ostium and His bundle with cardiac catheterization.The high of Koch's triangle were measured by multiangle projection respectively.Results:Koch's triangle is obviously different in these patients.The minimal size show in left anterior oblique(LAO),but the maximal size show in right anterior oblique(RAO) with caudal.Conclusion:Slow pathway locate is below in small Koch's triangle group,RAO with caudal projection can be used in ablation of slow pathway,but slow pathway locate in area of middle-posterior 1/3 of Koch's triangle in larger Koch's triangle group.