心房纤维化致右房电极植入失败病例1例

A case report of right atrial electrode implantation failure caused by atrial fibrosis

1例长期房性心动过速患者射频消融术中出现心脏停搏,并在三维标测系统指导下行右心房基质标测,后行双腔起搏器植入。三维标测系统指导下标测右心房游离壁及前壁发现大片低电压及疤痕区。起搏器植入术中多次调试右心房电极,起搏阈值参数均不理想,右心房电极植入失败。长期房性心动过速可能导致心房电重构、心房纤维化,从而导致右心房电极植入失败。

In this study,the intraoperative cardiac arrest in a patient with long-term atrial tachycardia during radiofrequency ablation were observed,and the patient was performed the right atrial matrix mapping under the guidance of a three-dimensional mapping system and implemented the dual chamber pacemaker implantation.Under the guidance of the three-dimensional mapping system,large areas of low voltage and scarring were found on the free wall and anterior wall of the right atrium on the mapping side.During pacemaker implantation,the right atrial electrode was adjusted by multiple times,but the pacing threshold parameters were not ideal,resulting in the failure of the right atrial electrode implantation.Long-term atrial tachycardia may lead to atrial electrical remodeling and atrial fibrosis,thereby causing failure of right atrial electrode implantation.