摘要
目的探讨青年心房扑动(简称房扑)接受导管消融的患者,合并病窦综合征(SSS)的临床情况和电生理特征。方法回顾性分析本中心2016年7月至2019年6月连续收治的20例15~40岁青年房扑消融患者,按照临床结局和随访结果,分为合并SSS(A组)和不合并SSS(B组)两组,对两组患者的临床情况和消融术中电生理特征进行对比分析。结果与不合并SSS者(B组,n=15)相比,合并SSS者(A组,n=5)半数以上既往有心肌炎病史(60.00%vs 0.00%,P=0.01),消融术前绝大多数呈持续性房扑(80.00%vs 33.33%,P=0.13),F波宽大、房扑周长(FCL)更长[(319.00±23.93)ms vs(247.31±62.07)ms,P=0.02]、多为三尖瓣环峡部依赖性顺钟向大折返(80.00%vs 13.33%,P=0.01),且多数患者心房基质标测存在自发右房瘢痕(80.00%vs 22.67%,P=0.11)。结论青年房扑合并SSS者心房扑动周长较长、多为三尖瓣环峡部依赖性顺钟向大折返、且存在右房瘢痕。
Objective To investigate the clinical features and electrophysiological characteristics of sick sinus syndrome(SSS)in young patients with atrial flutter(AFL)undergoing catheter ablation.Methods This study retrospectively analyzed 20 consecutive cases of AFL ablation in adolescents aged 15-40 years from July 2016 to June 2019.According to the clinical outcomes and follow-up results,the patients were divided into two groups:SSS(Group A,n=15)and Non-SSS(Group B,n=5).The clinical factors and electrophysiological characteristics during ablation were compared and analyzed between the two groups.Results More than half of the AFL adolescents with SSS had a history of myocarditis(60%vs 0%,P=0.03),and most of them had persistent AFL(80%vs 33.33%,P=0.04)before ablation.They had longer flutter cycle length(FCL)(319.00±23.93 ms vs 247.31±62.07 ms)than those without SSS.The electrophysiological characteristics of tricuspid annular isthmus dependent clockwise reentry(80%vs 13.33%,P=0.02)were observed in most patients with SSS,and spontaneous right atrial scarring was detected(80%vs 22.67%,P=0.04).Conclusion In young patients with AFL and SSS,the FCL is longer and conforms to tricuspid annular isthmus dependent clockwise reentry,most of them have spontaneous scars in the right atrium.[Chinese Journal of Cardiac Pacing and Electrophysiology,2020,34(1):25-28]
作者
李康
丁燕生
范芳芳
王禹川
盛琴慧
蒋捷
褚松筠
周菁
LI Kang;DING Yan-sheng;FAN Fang-fang;WANG Yu-chuan;SHENG Qin-hui;JIANG Jie;CHU Song-yun;ZHOU Jing(Department of Cardiology,Peking University First Hospital,Beijing 100034,China)
出处
《中国心脏起搏与心电生理杂志》
2020年第1期25-28,共4页
Chinese Journal of Cardiac Pacing and Electrophysiology
关键词
电生理学
青年
心房扑动
病窦综合征
心房扑动周长
心房自发瘢痕
Electrocardiophysiology
Adolescents
Atrial flutter
Sick sinus syndrome
Flutter cycle length
Atrial spontaneous scar
作者简介
李康(1974-),女(汉族),湖北仙桃人,副主任医师,医学博士,研究方向为导管消融与心脏起搏;通讯作者:周菁,E-mail:zhoujing123@gmail.com
