CAJ | 학술논문

目的报道三尖瓣环非间隔部位起源的房性心动过速(简称房速)体表心电图特点及射频消融治疗效果。方法5例房速均被证实起源于三尖瓣环下侧壁部位并行射频消融治疗。影像学消融靶点位于三尖瓣环，局部电图可见 A 波和 V 波，且 A ∶ V ＜2，V 波的振幅＞0.5mV。结果5例房速均射频消融成功，部位位于三尖瓣环下侧壁，靶点局部 A 波激动时间领先体表心电图 P 波起点（48±16）ms，AV比值（0.5±0.4）。三尖瓣环下侧壁起源的房速 P 波特点：I、avL、aVR 导联 P 波正向，Ⅱ、Ⅲ、aVF 导联 P 波负向，V1~V6导联 P 波负向。结论三尖瓣环非间隔部位是右房房速的一个重要起源点，其体表心电图有明确特征。
목적보도삼첨판배비간격부위기원적방성심동과속(간칭방속)체표심전도특점급사빈소융치료효과。방법5례방속균피증실기원우삼첨판배하측벽부위병행사빈소융치료。영상학소융파점위우삼첨판배，국부전도가견 A 파화 V 파，차 A ∶ V ＜2，V 파적진폭＞0.5mV。결과5례방속균사빈소융성공，부위위우삼첨판배하측벽，파점국부 A 파격동시간령선체표심전도 P 파기점（48±16）ms，AV비치（0.5±0.4）。삼첨판배하측벽기원적방속 P 파특점：I、avL、aVR 도련 P 파정향，Ⅱ、Ⅲ、aVF 도련 P 파부향，V1~V6도련 P 파부향。결론삼첨판배비간격부위시우방방속적일개중요기원점，기체표심전도유명학특정。
Objective To delineate the electrocardiographic features and results of radiofrequency catheter ablation (RFCA) of atrial tachycardia (AT) originating from the nonseptal region of tricuspid annulus (TA). Methods The study included 5 patients with ATs originating from the nonseptal region of TA. The location of the AV annuli was confirmed by using the AV ratio of the local electrograms (A∶V<2) and the amplitude of the ventricular electrograms (>0.5mV) in addition to the anatomic findings under fluoroscopic guidance. Results All AT were successfully ablated by RFCA. The annular focus was localized to the inferolateral TA. The target atrial electrogram precedes the onset of P wave in surface electrocardiogram by (48±16)ms. The AV ratio of the local electrograms was (0.5±0.4). In the inferolateral TA, the P wave morphology was positive in I, aVL, aVR, but was inverted in inferior and Vl-V6 leads. Conclusion The nonseptal region of TA is an important site of right AT origin with characteristic P wave morphology.