起源于上腔静脉的心房颤动的电生理特点及射频消融Atrial fibrillation originated from superior vena cava and its ablation
龙德勇,董建增,马长生,刘兴鹏,喻荣辉,汤日波,田颖,陶海龙,李旭平,史力生,郑斌,何华
摘要(Abstract)：
目的探讨上腔静脉起源的心房颤动(房颤)的临床及电生理特点。方法回顾过去2年来我中心经电生理证实的起源于上腔静脉的房颤病例,分析其体表心电图及心腔内电生理特点。结果期间共16例患者(男/女=12例/4例,平均年龄53·4±10·6岁,阵发性/持续性房颤=11例/5例)经电生理证实房颤起源于上腔静脉,占同期接受导管消融病例的2·9%(16/545)。16例患者中,仅2例可以根据体表心电图诊断房颤为上腔静脉起源,此2例在上腔静脉隔离后房颤终止。另外14例体表心电图不典型者,先行左心房消融后,继续右心房标测过程中见上腔静脉驱动,隔离上腔静脉后房颤终止、不被诱发。隔离上腔静脉的平均放电次数6±2次,平均操作时间10±3min。上腔静脉-右心房之间肌束连接平均为3±1束。随访期间仅1例于术后3个月时出现心房扑动样发作。术后除1例出现右侧股静脉穿刺点血肿外,无其他并发症。结论上腔静脉可为肺静脉、左心房之外重要的房颤起源部位。对于心电图不典型者,完成左心房消融后如房颤不终止或易被诱发,则应考虑到上腔静脉起源的可能。
关键词(KeyWords)： 心房颤动;导管消融术;腔静脉,上
基金项目(Foundation):
作者(Author): 龙德勇,董建增,马长生,刘兴鹏,喻荣辉,汤日波,田颖,陶海龙,李旭平,史力生,郑斌,何华
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