分支型室速的电生理机制、标测和消融-PART2
In A (recorded before the third application of radiofrequency current), the left ventricular electrogram shows a P potential preceding the QRS by 25 milliseconds that fuses with the local ventricular potential (V).This was the earliest ventricular potential recorded during mapping and preceded the QRS by 18 milliseconds. Ablation at this site was unsuccessful.
In B (recorded before the forth application of radiofrequency current), the left ventricular electrogram recorded the earliest P potential (P-QRS, 40 milliseconds). Ablation at this site was successful, even though the timing of the local ventricularpotential was later than in A (V-QRS, 12 milliseconds).
靶点位于后间隔近心尖处
A, Small area with a single retrograde PP in patient No. 5 with ILVT during SR. Note that an area with retroPP (asterisk) was located within the posterior Purkinje fiber network and marked with blue and pink tags.
This short and sharp potential is characterized by a high frequency and low amplitude after the PP (arrow). When mapping ILVT, the site of mechanic termination was marked by the dark brown tag and was located close to the area with the earliest abnormal potential. Note that an area with abnormal potentials (asterisk) following the PP (arrow) was located within the posterior Purkinje fiber network and was labeled with blue and pink tags.
Sites with single abnormal potentials and longer intervals from the PP to this abnormal potential were marked with blue tags. Sites with multiple abnormal potentials and shorter intervals from the PP to the first abnormal potential were marked with pink tags.
2005年,中华心血管杂志英文版,有一例病人复发,左后分支阻滞恢复。文章认为消融至左后分支阻滞非常重要。
During SR, electroanatomic Mapping, X-ray and Intracardiac electrogram target at the site of successful ablation in patient No. 9 with ILVT.
The ablation points (red point) were noted at the area of FAP (pink point). The x-ray showed that the ablation catheter was located at the left ventricular septum slightly inferoposterior to the LPF during SR (RAO 30°and LAO 45°).
The FAPs (red arrow) were recorded at the site (ABLd) of successful ablation
in intracardiac electrogram.