王琎,龙德勇,蒋晨曦,桑才华,汤日波,喻荣辉,李松南,刘相飞,杜昕,董建增,马长生

• 1:北京市心肺血管疾病研究所首都医科大学附属北京安贞医院心内科
• 2:胜利油田中心医院心内科

摘要(Abstract)：

目的探讨起源于三尖瓣环(TA)顶部的室性期前收缩(PVC)体表心电图特点、腔内心电图特征和导管消融治疗效果。方法纳入首都医科大学附属北京安贞医院2016年1月至2016年12月共263例室性心律失常患者,其中220例行导管消融治疗,证实起源于TA顶部的PVC患者共8例,分析8例患者心电图特点。结果 8例患者全部消融成功,随访6个月无复发。体表心电图QRS波均呈左束支传导阻滞样图形,Ⅰ导联R波高于窦性心律时[(0.75±0.12)mV比(0.93±0.17)m V,P<0.005],下壁(Ⅱ、Ⅲ、a VF)导联与窦性心律时相近,显著低于右心室流出道起源者(P<0.01);a VR导联以负向为主,a VL导联则多为正向,均与窦性心律时相似,而临近的右心室流出道前壁起源aVL导联多为负向;胸前导联移行通常在V_3～V_4晚于窦性心律时;QRS波常见切迹,以下壁导联和V_4～V_6导联多见。靶点处常可见到反转电位或负向起始电位。结论起源于TA顶部的PVC具有一定的心电图特征,本研究通过体表心电图早期识别起源部位,采用特殊的导管到位方式,均成功通过导管消融术有效终止PVC发作。

关键词(KeyWords)： 三尖瓣环;室性期前收缩;心电图特征;导管消融

Abstract:

Keywords:

基金项目(Foundation): 国家重点研发计划(2017YFC1307800);; 国家自然科学基金(81770326);; 北京市医院管理局“青苗”计划(QML20160601)

作者(Author): 王琎,龙德勇,蒋晨曦,桑才华,汤日波,喻荣辉,李松南,刘相飞,杜昕,董建增,马长生

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