王华,李博,郝京霞,张会敏,张涛,张英谦

• 1:河北省儿童医院心内科
• 2:首都医科大学附属北京安贞医院心内科

摘要(Abstract)：

目的 通过术中测量三尖瓣-下腔静脉峡部（CTI）依赖心房扑动（房扑）消融前后峡部传导间期百分比，探讨峡部传导间期百分比在CTI线性阻滞消融终点评估的临床价值。方法 本研究入组2021年2月至2023年2月诊断CTI依赖房扑并行射频消融治疗患者共37例（首都医科大学附属北京安贞医院35例，河北省儿童医院2例），术中均诱发CTI依赖房扑，并采用解剖消融方法沿三尖瓣环至下腔静脉行线性消融，术后经右心房激动标测验证CTI呈线性阻滞。分别统计入组患者心动过速周长（TCL）、冠状窦起搏下消融前局部传导间期（P-ABL1）、冠状窦起搏下消融后局部传导间期（P-ABL2），计算局部传导期间百分比（P-ABL2/TCL）。评估P-ABL2/TCL对诊断CTI双向传导阻滞的价值，并通过消融后激动顺序验证其有效性。结果 所有入组患者均采用解剖方法行射频消融，并行激动标测验证CTI呈线性阻滞。术中诱发TCL为（310.00±46.32）ms。术前测定P-ABL1为（92.16±27.65）ms，术后测量P-ABL2为（173.65±16.35）ms，两组数据差异有统计学意义（P <0.001）。术后P-ABL2/TCL为（0.81±0.12）。P-ABL2/TCL越接近1，评估CTI双向传导阻滞的特异性及有效性越高。结论 采用术前局部传导间期可预估CTI阻滞终点，并结合术后P-ABL2/TCL的方法可提高CTI阻滞线完整性，减少反复消融，提高手术成功率。

关键词(KeyWords)： 心房扑动;局部传导间期百分比;射频消融;三尖瓣-下腔静脉峡部;双向传导阻滞

Abstract:

Keywords:

基金项目(Foundation): 河北省医学科学研究课题计划项目（20220774）

作者(Author): 王华,李博,郝京霞,张会敏,张涛,张英谦

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