心脏summit区室性早搏的电生理特点及导管消融

··summit*孙源君张树龙summit、LCCLCC、。summitDOI10．13333/j．cnki．cjcpe．2015．04．0012015－8－101533http//．cnki．net/kcms/detail/42．1421．Ｒ．20150810．1533．001．htmlＲ541．7Ｒ454．1A1007－2659201504－0283－05rightventricularoutflowＲVOTleftventricu-laroutflowLVOTsummit。。summit、greatcardiacveinGCVsummitGCV/anteriorinterventricularveinAIV、leftcoronarycuspLCC、aortomitralcontinuityAMCＲVOT11。summit。AtienzaFetal．CircArrhythmElectrophysiol20103616－623．DixitSetal．JCardiovascElectrophysiol2014．Epubaheadofprint1Summit*20130230321160111988－。[e-mail]1———GCV/AIVGCV/AIVGCV/AIV2－5。GCV/AIVV1rSQSV6ＲⅠrS。Steven614summitGCV642．8%428．6%428．6%6116．7%。Yamada727summitGCV/AIV。summitGCV·382·2015294。GCV/AIVQＲS20msGCV/AIV20～30W＜40℃230～40W＜40℃3。271970．4%GCV/AIV14、414．8%、414．8%summit、V1、QaVL/QaVＲ1．1V5V6SGCV/AIV70%100%。Ｒ。GCV/AIVＲＲsummitQaVL/QaVＲ＞1．48、ＲⅢ/ＲⅡ＞1．17、PDI＞0．69。GCVPVCPMGCVQＲS26ms。YamadaTetal．CircArrhythmElectrophysiol201036616－6232GCV/AIVYamadaTetal．CircArrhythmElectrophysiol201036616－6233·482·summitGCVGCVGCV。15s5mm7。10。2LCCLCCsummitGCV/AIV、、＜5mm、、711－12。GCV/AIV“”summitLCCLCC13。Jauregui1216summit956%LCC/LCCLCCAIVGVC＜13．5mmQaVL/QaVＲ＜1．45LCCLCC。①②LVOTSLVOTＲCCLCC414。Ouyang1416LCCSLCC7．4±3．5mmLCC。ABLVOTＲCCCDLCCSL1SLVOTLCCＲCC。CSMapSL1SL1。OuyangFetal．CircArrhythmElectrophysiol201473445－4554Xsummit、。Kimura151summitLCCQＲSGCV5LCC。3AMCAMCLCC、6。AMCQＲSＲIＲＲsV1qＲV6Ｒ16。LCC17。AMC18。AMCLCCＲCC。4ＲVOTFrankel192ＲVOTsummit7。1AIV、LCC、AIVQＲS25msLAD。AIVLCCAIV5ms15mmLCCAIV10ms。ＲVOTＲVOTAIV2ms9mm·582·2015294LCCLCC2LCC1KimuraTetal．HeartLungCirc2014232193－1965、、AMCVTStevenDetal．CircArrhythmElectrophysiol20092660－6666AMC4s2．5。1V3AIVLADＲVOTＲVOTAIV8mm。ＲVOTAIVGCV/AIV＜10mm。AIVLADＲVOTLAD2mm2～3cm20ＲVOT7。5summit。summit21sum-mit。1．summitJ．201524192ObelOAd'AvilaANeuzilPetal．AblationofleftventricularepicardialoutflowtracttachycardiafromthedistalgreatcardiacveinJ．JAmCollCardiol200648918133BamanTSIlgKJGuptaSKetal．Mappingandablationofepi-cardialidiopathicventriculararrhythmiasfromwithinthecoronaryve-noussystemJ．CircArrhythmElectrophysiol201032744．J．20142854075VallèsEBazanVMarchlinskiFE．ECGcriteriatoidentifyepicar-dialventriculartachycardiainnonischemiccardiomyopathyJ．CircArrhythmElectrophysiol20103636StevenDPottCBittnerAetal．IdiopathicventricularoutflowtractarrhythmiasfromthegreatcardiacveinchallengesandrisksofcatheterablationJ．IntJCardiol20136953667YamadaTMcElderryHTDoppalapudiHetal．Idiopathicven-triculararrhythmiasoriginatingfromtheleftventricularsummitana-tomicconceptsrelevanttoablationJ．CircArrhythmElectrophysi-ol2010366168ItoSTadaHNaitoSetal．DevelopmentandvalidationofanECGalgorithmforidentifyingtheoptimalablationsiteforidiopathicventricularoutflowtracttachycardiaJ．JCardiovascElectrophysi-ol20031412809HachiyaHHiraoKSasakiTetal．NovelECGPredictorofdifficultcasesofoutflowtractventriculartachycardiaJ．CircJ20107425610ＲeithmannCSteinbiglerPFiekM．Simultaneouscoronaryangiog-raphyduringtitrationofradiofrequencyenergyforablationofleftventricularsummittachycardiainthe＇inaccessiblearea＇J．Eu-ropace20131513211DanielsDVLuYYMortonJBetal．Idiopathicepicardialleftven-triculartachycardiaoriginatingremotefromthesinusofValsalvaelec-trophysiologicalcharacteristicscatheterablationandidentificationfromthe12-leadelectrocardiogramJ．Circulation2006113165912JaureguiAbularachMECamposBParkKMetal．AblationofventriculararrhythmiasarisingneartheanteriorepicardialveinsfromtheleftsinusofValsalvaregionECGfeaturesanatomicdistanceandoutcomeJ．HeartＲhythm201296865·682·summitAAIVＲVOTＲVOTBAIVＲVOTCＲVOTAIV1FrankelDSetal．CircArrhythmElectrophysiol201475984－9857、AIV、LADＲVOT13ItoSTadaHNaitoSetal．Simultaneousmappingintheleftsi-nusofValsalvaandcoronaryvenoussystempredictssuccessfulcath-eterablationfromtheleftsinusofValsalvaJ．PacingClinElectro-physiol200528S15014OuyangFMathewSWuSetal．Ventriculararrhythmiasarisingfromtheleftventricularoutflowtractbelowtheaorticsinuscuspsmappingandcatheterablationviatransseptalapproachandelectro-cardiographiccharacteristicsJ．CircArrhythmElectrophysiol20147344515KimuraTTakatsukiSFukumotoKetal．IdiopathicventriculartachycardiacuredbyradiofrequencyapplicationfromthedistalgreatcardiacveinandtheleftcoronarycuspJ．HeartLungCirc201423219316DixitSGerstenfeldEPLinDetal．Identificationofdistinctelec-trocardiographicpatternsfromthebasalleftventricledistinguishingmedialandlateralsitesoforigininpatientswithidiopathicventricu-lartachycardiaJ．HeartＲhythm20052548517DixitSMarchlinskiFE．Clinicalcharacteristicsandcatheterabla-tionofleftventricularoutflowtracttachycardiaJ．CurrCardiolＲep20013430518DixitSGerstenfeldEPLinDetal．Identificationofdistinctelec-trocardiographicpatternsfrombasalleftventricledistinguishingme-dialandlateralsitesoforigininpatientswithidiopathicventriculartachycardiaJ．HeartＲhythm2005248519FrankelDSMountantonakisSEDahuMIetal．EliminationofventriculararrhythmiasoriginatingfromtheanteriorinterventricularveinwithablationintherightventricularoutflowtractJ．CircAr-rhythmElectrophysiol20147598420VaseghiMCesarioDAMahajanAetal．Catheterablationofrightventricularoutflowtracttachycardiavalueofdefiningcorona