房室结折返性心动过速慢径消融靶点定位的量化指标

Quantitative Parameters of Target Location in Slow Pathway Ablation of Atrioventricular Nodal Reentrant Tachycardia

目的 :通过对有效靶点和无效靶点的多参数分析以研究慢径消融靶点的综合判定方法。方法 :对 80例房室结双径路慢径消融成功患者的 63 4个靶点分为有效靶点组 (n =184)和无效靶点组 (n =45 0 ) ,分别测定冠状静脉窦口A波起始至希氏束H波的间期 (Acso H) ,希氏束远端A波起始至靶点A波起始的间期 (AHIS At)以及冠状静脉窦口A波起始至靶点A波起始的间期 (Acso At)。测定靶点A波和V波振幅以及A/V值。将以上结果行统计学处理。结果 :有效靶点组与无效靶点组比较 ,除Acso At两组比较无差异之外 ,其他各值均有显著性差异。结论 :本文结果提示Koch三角大小的激动传导时间无明显差异 ,有效靶点位置A波振幅 <2mV ,V波振幅>10mV ,A/V值 <0 2 ,Acso At≥ 0ms是重要的参考量化指标 ,均提示靶点位于冠状静脉窦口附近三尖瓣环侧。

Objective: To determine the parameters of ablation target sites in slow pathway. Methods: Six hundred and thirty four ablation target sites were classified into success group ( n =184) and failure group ( n =450). The conductive intervals between A wave of coronary sinus orifice and H wave of His's bundle (Acso H),between A wave of His's bundle and A wave of target site (A HIS At),and the conductive time between A wave of coronary sinus orifice and A wave of target site (Acso At) were measured respectively. The amplitude of A and V waves as well as A/V ratio were also measured respectively. The obtained data were analyzed by statistical SPSS 8.0 software. Results: All parameters showed significant difference except those of Acso H in both groups. Conclusion: The effective target parameters are A wave<2 mV,V wave>10 mV, A/V ratio less<0 2 and Acso At ≥0 ms. These results suggest that the ablation target site is located near coronary sinus orifice level and near tricuspid valve annulus.