【摘要】 目的评价导管消融心脏外科联合迷宫术后复发房性心动过速(简称房速)的电解剖基质及射频消融。方法回顾性分析本院2016年1月至2019年1月心脏外科联合迷宫术后复发房速消融病例,所有房速应用三维标测于双房电解剖标测,结合拖带标测,明确房速机制后进行线性及基质消融。结果共入选27例,诱发出33种心动过速。右房起源房速7例,所有右房起源房速均与切口和/或三尖瓣环大折返相关;左房房速26例,大折返机制15例,微折返机制11例。首次消融手术成功率93.9%(31/33)。平均随访(31±18)个月,有5例患者复发。2例进行二次消融,总体手术成功率81.5%(22/27)。结论心脏外科联合迷宫术后房速患者行导管消融治疗安全、有效。更多还原

【Abstract】 Objective To analyze the electrophysiological mechanisms and the effect of radiofrquency catheter ablation of recurrent atrial tachycardias(ATs) after cardiac surgery and concomitant MAZE procedure. Methods Twenty-seven patients with ATs post Maze and concomitant open-heart surgery were included. According to high density precise mapping, activation mapping, voltage mapping and entrainment mapping, they underwent electrophysiological study and ablation which was guided by three-dimensional mapping system. Results The 33 mappable ATs included 7 right atrium ATs and 26 left atrium ATs. All of the right atrium ATs were marco-reentrant around the tricuspid annulus and/or incision line. ATs in left atrium were macro-reentry ATs(15/26) and localized reentry ATs(11/26), respectively. 31/33(93.9%) ATs were successfully terminated during procedure. After mean follow-up of(31±18) months, recurrences were observed in 5 patients after the first time catheter ablation. 2 patients received second ablation and the achievement of freedom from arrhythmias reached 81.5%( 22/27). Conclusion Catheter ablation of ATs post Maze with concomitant surgery is save and feasible.[Chinese Journal of Cardiac Pacing and Electrophysiology,2020,34(6):555-559]更多还原