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目的 :本文报道一例在高海拔地区 (海拔 2 2 6 0m)经射频消融成功治疗起源于左上肺静脉的心房颤动 (简称房颤 ) ,伴有频发房性早搏 (房早 )、短阵房性心动过速的阵发性房颤 ;方法 :电生理检查放置 6F多极导管电极于右室 ,His束及冠状静脉窦 (CS) ,行一次性房间隔穿刺 ,将 2根 1 0极可控标测导管及一根大头导管通过长鞘送入左、右上肺静脉 ,选择性肺静脉造影证实肺静脉开口部位 ;结果 :静脉滴注异丙肾上腺素后诱发出房早开始发作时的心内电图 ,最早激动位于左上肺静脉内 ,比体表心电图房早的P′起点提前 6 0秒 ,在最早心房激动点处以 1 5W～ 2 0W的输出功率消融 5 6 0秒 ,消融成功 ,静脉滴注异丙肾上腺素亦未再诱发房颤 ,随访一个月无并发症 ,有房早给予心律平后消失 ,无房颤发作 ;结论 :射频消融治疗起源于肺静脉的房颤效果好且相对安全
OBJECTIVE: In this paper, we report a case of atrial fibrillation (AF) originated in the left upper pulmonary vein at high altitudes (22,600 m) by radiofrequency ablation, with frequent atrial premature beats Tachycardia paroxysmal atrial fibrillation; Methods: electrophysiological examination placed 6F multi-pole catheter electrode in the right ventricle, His bundle and coronary sinus (CS), a one-time atrial septal puncture, the two 10 very controllable The catheter and a large catheter through the long sheath into the left and right upper pulmonary veins, pulmonary veins confirmed by selective pulmonary venography; Results: intravenous infusion of isoproterenol induced atrial seizure early onset of intracardiac electrocardiogram, The earliest excitement located in the left upper pulmonary vein, early than the body surface ECG P ’start early 60 seconds at the earliest atrial activation point at 15W ~ 20W output power ablation 5600 seconds ablation success, intravenous infusion of isopropyl Adrenaline did not induce atrial fibrillation anymore. There was no complication after one month of follow-up. Atrial fibrillation disappeared early without atrial fibrillation. CONCLUSION: Radiofrequency ablation is effective and relatively safe for atrial fibrillation originated from pulmonary veins