导管消融房颤现状与房颤发生机制黄从新

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) 顶部顶部 (5)间隔部间隔部 (6)二尖瓣环后部二尖瓣环后部 (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 起搏时间起

3、搏时间 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 起搏时间起搏时间 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 起搏时间起搏时间 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、例房颤患者例房颤患者 capv 随访随访12月月 1例复发例复发 29例（例（17.6%）复发）复发 avl rv i 36008406008101040710 440 100 50 0 4.1 sec hfs 停止 6003600 arterial pressure (mmhg) vv 神经反射神经反射 (r-rinterval) vv jackmanandnakagawa,hrs2005 10例例“迷走神经性房颤迷走神经性房颤” hfs诱发神经反射诱发神经反射 7例诱发出迷走反射例诱发出迷走反射3例未诱发出迷走反射例未诱发出迷走反射 神经丛消融神经丛消融capv 随访随访8.3 2.8 月月 2例无复发例无复发均无复发均无复发 scanavacca et al. circulation, 2006, 114:876 follow-up(days) freedomfromrecurr