導(dǎo)管消融房顫現(xiàn)狀與房顫發(fā)生機(jī)制黃從新

1、 51.3 48.7 77.1% 22.9% 78.8 71.5 62.3 21.2 28.5 37.7 p0.05 lupv llpv rupv rlpv icv scv lupv llpv rupv rlpv icv scv lupv llpv rupv rlpv icv scv lupv llpv rupv rlpv icv scv lupv llpv rupv rlpv icv scv lupv llpv rupv rlpv icv scv estner et al.europace,2008,8 crawford et al. j interv card electrophysiol

2、 ,2008,21:2733 (1) pv前庭前庭 (2) 后壁后壁(3) 前壁前壁 (4) 頂部頂部 (5)間隔部間隔部 (6)二尖瓣環(huán)后部二尖瓣環(huán)后部 (7)前壁前壁 (8)左心耳左心耳 tada et al. j cardiovasc electrophysiol, 2008, 19, 606-612 ivc ra ripv raa rspv svc lv lpa lspv lipv rv la laa luz,jianghandsunnypo.circarrhythmiaelectrophysiol.2008 200 160 120 80 40 123456baseline 起搏時(shí)間起

3、搏時(shí)間 erp (ms) lspv erp2xthreshold erp10 xthreshold luz,jianghandsunnypo.circarrhythmiaelectrophysiol.2008 200 160 120 80 40 123456baseline erp (ms) lspv erp2xthreshold erp10 xthreshold post-abl gp ablation 起搏時(shí)間起搏時(shí)間 luz,jianghandsunnypo.circarrhythmiaelectrophysiol.2008 123456baseline wov (ms) 消融消融gp

4、0 400 800 1200 1600 post-abl luz,jianghandsunnypo.circarrhythmiaelectrophysiol.2008 200 160 120 80 40 123456post-abl erp (ms) lspv erp2xthreshold erp10 xthreshold 起搏時(shí)間起搏時(shí)間 luz,jianghandsunnypo.circarrhythmiaelectrophysiol.2008 post-abl 123456post-abl 0 400 800 1200 1600 wov (ms) luz,jianghandsunnypo

5、.circarrhythmiaelectrophysiol.2008 post-abl lu z, jiang h and sunny po. jce. 2008 100 ms ii raa rspv ripv ra aa mid gp rotor firing ra cfae + + + lu z, jiang h and sunny po. jce. 2008 ii raa rspv ripv ra aa mid gp 100 ms lu z, jiang h and sunny po. jce. 2008 lu z, jiang h and sunny po. jce. 2008 297

6、例房顫患者例房顫患者 capv 隨訪隨訪12月月 1例復(fù)發(fā)例復(fù)發(fā) 29例（例（17.6%）復(fù)發(fā)）復(fù)發(fā) avl rv i 36008406008101040710 440 100 50 0 4.1 sec hfs 停止 6003600 arterial pressure (mmhg) vv 神經(jīng)反射神經(jīng)反射 (r-rinterval) vv jackmanandnakagawa,hrs2005 10例例“迷走神經(jīng)性房顫迷走神經(jīng)性房顫” hfs誘發(fā)神經(jīng)反射誘發(fā)神經(jīng)反射 7例誘發(fā)出迷走反射例誘發(fā)出迷走反射3例未誘發(fā)出迷走反射例未誘發(fā)出迷走反射 神經(jīng)叢消融神經(jīng)叢消融capv 隨訪隨訪8.3 2.8 月月 2例無復(fù)發(fā)例無復(fù)發(fā)均無復(fù)發(fā)均無復(fù)發(fā) scanavacca et al. circulation, 2006, 114:876 follow-up(days) freedomfromrecurr