【摘要】 目的报告一例罕见的心房分离,探讨其发生原因有助于加深对心房扑动(房扑)、心房颤动(房颤)发生机制的认识。方法心内电生理检查,常规导管放置,测定各部位不应期,绣发房扑、房颤,并对其进行标测,用经典方法消融房扑。结果本例心房分离表现为右房房颤、左房房扑,心室受右房房颤所控制。射频消融后,房扑不能诱发,同时心房分离现象亦消失。结论心房分离可能由心房之间不应期不同所致,左右心房自我保护性阻滞使各自节律得以维持。对于房扑始动的心房分离,可经射频消融成功。更多还原

【Abstract】 Objective Report an unusual case with atrial dissociation(AD)and the mechanism was investigated.Methods Catheters were put routinely and endocardial electrophysiological study was carried out.Refractory periods of different positions were measured,atrial flutter/atrial fibrillation were induced and the activation sequence was mapped.Then the atrial flutter was ablated with conventional methods.Re- sults In this particular case,AD manifested as right atrial fibrillation and left atrial flutter,the ventricles were controlled by the right atrial fibrillation.After radiofrequency catheter ablation,atrial flutter could not be induced,and AD disappeared.Conclusion AD may be caused by differences of the refractory periods of the atria.Each atrium had its functional self protective block zone resulting in occurrence of different rhythms at the same time.AD,which was initiated by atrial flutter,could be ablated successfully.更多还原