Shah Dipen, Jaïs Pierre, Haïssaguerre Michel
Division of Cardiology, Hopital Cantonal de Geneve, Geneve, Switzerland.
Card Electrophysiol Rev. 2002 Dec;6(4):365-70. doi: 10.1023/a:1021171922099.
Right atrial reentry which does not critically depend upon activation through the cavotricuspid isthmus is considered to be a subtype of atypical flutter. Diagnosis is dependent upon demonstrating the nonparticipation of the cavotricuspid isthmus. Right atrial free wall atriotomy incisions, the superior vena cava, the inferior vena cava, electrically silent or mute areas, incomplete variants of the posterior intercaval crista terminalis line of block and other functional/anisotropic lines of block form the central barriers around which macroreentry occurs. The length, location and orientation of fixed lines of block such as atriotomy incisions are important determinants of their arrhythmogenicity. Successful catheter ablation depends upon delineating the circuit in order to choose the optimal isthmus for ablation and producing complete block across it.
不严重依赖通过腔静脉三尖瓣峡部激动的右房折返被认为是非典型房扑的一种亚型。诊断依赖于证实腔静脉三尖瓣峡部未参与其中。右房游离壁心房切开术切口、上腔静脉、下腔静脉、电静止或沉默区域、后腔静脉间界嵴阻滞线的不完全变异以及其他功能性/各向异性阻滞线形成了围绕其发生大折返的中央屏障。诸如心房切开术切口等固定阻滞线的长度、位置和方向是其致心律失常性的重要决定因素。成功的导管消融取决于描绘出折返环以便选择最佳的消融峡部并实现跨峡部的完全阻滞。
