胡志鹏,梁卓,刘旭,张涛,王云龙

• 1:首都医科大学附属北京安贞医院心内科

摘要(Abstract)：

目的 研究右心室节制索（MB）上右束支（RBB）起源的特发性室性心律失常（VAs）的电生理特征及射频消融疗效。方法 回顾性分析2019年4月至2022年7月于首都医科大学附属北京安贞医院心律失常中心经电生理检查及射频消融证实起源于右心室MB上RBB的10例特发性VAs患者。通过在MB处行激动及起搏标测，分析其体表心电图特征、电生理特点、成功消融靶点处电位特征并观察分析射频消融的疗效。结果 起源于MB上RBB的特发性VAs体表心电图呈典型的左束支传导阻滞（LBBB）图形，电轴左偏，发作VAs时呈现较窄的QRS波，V1、V2导联为rS波，且S波无顿挫，VAs时R波均移行于V4～V6导联，晚于窦性心律，V6导联均有正向R波。在VAs时最早激动位点处均有领先的RBB电位，术中消融领先RBB电位均有效地消除了VAs，消融后6例出现右束支传导阻滞，随访过程中2例恢复。结论 MB上RBB的特发性VAs体表心电图表现为较窄的QRS波，典型LBBB，电轴左偏，胸前导联R波移行晚于窦性心律。消融最早激动位点前领先的RBB电位成功消除了VAs。

关键词(KeyWords)： 射频消融;节制索;右束支;室性心律失常

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目（81970272）

作者(Author): 胡志鹏,梁卓,刘旭,张涛,王云龙

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