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目的探讨主动脉窦造影特征和局部电生理特点的临床应用。方法选取因快速性心律失常而行射频导管消融(RFCA)治疗患者40例,标测导管经逆行主动脉途径测量窦性心律下3个主动脉窦的心房电位(A)和心室电位(V)的振幅,计算心房和心室电位的振幅比率(A/V)。结合主动脉造影的X线影像,分析各主动脉窦的相对位置关系。结果所有患者左冠窦(LCC)和右冠窦(RCC)心房电位振幅均小于心室,LCC的A/V(0.41±0.15)和RCC的A/V(0.10±0.07)均<1.0。而无冠窦(NCC)心房电位振幅均大于心室,A/V>1.0(5.13±2.56),明显大于另外两个主动脉窦的A/V值(P<0.000 1)。LAO45°和RAO30°主动脉造影图像显示RCC位于右前方,LCC位于左上方,NCC位于下后方。结论在射频导管消融过程中,主动脉窦X线影像和局部电生理特点对消融靶点的寻找具有定位作用,使主动脉窦内的消融更准确、安全和有效。
Objective To investigate the clinical features of aortic sinus and local electrophysiological characteristics. Methods Forty patients with RFCA underwent tachyarrhythmia. Atrial and ventricular potentials (A) and ventricular potentials (V) were measured by retrograde aortic approach in 3 aortic sinuses of sinus rhythm. The amplitude of the atrial and ventricular potentials was calculated (A / V). Combined with X-ray images of aortography, the relative position of aortic sinus was analyzed. Results The amplitude of atrial potential of left and right coronary sinus (LCC) and right coronary sinus (RCC) in all patients were less than that of the ventricles. The A / V (0.41 ± 0.15) and A / V (0.10 ± 0.07) of LCC were all <1.0. However, the amplitude of atrial potential in non-coronary sinus (NCC) was larger than that in the ventricles. A / V> 1.0 (5.13 ± 2.56) was significantly greater than that of the other two aortic sinus (P <0.0001). The LAO45 ° and RAO30 ° aortography images show RCC in the right front, LCC in the upper left, and NCC in the lower rear. Conclusion During radiofrequency catheter ablation, aortic sinus X-ray images and local electrophysiological features have a role in locating the ablation target, which makes the aortic sinus ablation more accurate, safe and effective.