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1
Evaluation of the surface ECG in detecting isthmus conduction block after ablation of typical atrial flutter.评估体表心电图在典型心房扑动消融后检测峡部传导阻滞的价值。
Clin Cardiol. 2010 Apr;33(4):E11-9. doi: 10.1002/clc.20479.
2
Impact of the ECG for detection of intraatrial conduction block after atrial flutter ablation.心电图对心房扑动消融术后房内传导阻滞检测的影响
Pacing Clin Electrophysiol. 1999 Oct;22(10):1457-65. doi: 10.1111/j.1540-8159.1999.tb00349.x.
3
Quantitative analysis of surface P-wave morphology in isthmus ablation for type 1 atrial flutter: differentiation between complete isthmus block and slow isthmus conduction.1型心房扑动峡部消融术中表面P波形态的定量分析：完全峡部阻滞与峡部缓慢传导的鉴别
Jpn Circ J. 1999 Apr;63(4):244-8. doi: 10.1253/jcj.63.244.
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Impact of transisthmus linear ablation of typical atrial flutter on coronary sinus activation time.典型心房扑动经峡部线性消融对冠状窦激动时间的影响。
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Double potential interval and transisthmus conduction time for prediction of cavotricuspid isthmus block after ablation of typical atrial flutter.用于预测典型心房扑动消融术后腔静脉-三尖瓣峡部阻滞的双电位间期和经峡部传导时间
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Differential pacing for distinguishing slow conduction from complete conduction block of the tricuspid-inferior vena cava isthmus after radiofrequency ablation for atrial flutter--role of transverse conduction through the crista terminalis.心房颤动射频消融术后通过差异性起搏鉴别三尖瓣-下腔静脉峡部的缓慢传导与完全性传导阻滞——经界嵴横向传导的作用
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Apparent bidirectional conduction block following radiofrequency catheter ablation of typical atrial flutter.典型心房扑动经导管射频消融术后出现的明显双向传导阻滞。
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本文引用的文献

1
Interatrial electrical connections: the precise location and preferential conduction.房间电连接：精确位置与优先传导
J Cardiovasc Electrophysiol. 2005 Oct;16(10):1077-86. doi: 10.1111/j.1540-8167.2005.40659.x.
2
Correlation between electrogram morphology and standard criteria to validate bidirectional cavotricuspid block in common atrial flutter ablation.普通心房颤动消融术中验证双向腔静脉三尖瓣阻滞的心电图形态与标准标准之间的相关性。
Europace. 2003 Oct;5(4):335-41. doi: 10.1016/s1099-5129(03)00084-9.
3
The usefulness of surface 12-lead electrocardiogram to predict intra-atrial conduction block after successful atrial flutter ablation.体表12导联心电图对预测心房扑动消融成功后心房内传导阻滞的作用。
J Electrocardiol. 2003 Jul;36(3):227-35. doi: 10.1016/s0022-0736(03)00047-5.
4
Double potential interval and transisthmus conduction time for prediction of cavotricuspid isthmus block after ablation of typical atrial flutter.用于预测典型心房扑动消融术后腔静脉-三尖瓣峡部阻滞的双电位间期和经峡部传导时间
J Interv Card Electrophysiol. 2002 Aug;7(1):77-82. doi: 10.1023/a:1020876317859.
5
Different patterns of interatrial conduction in clockwise and counterclockwise atrial flutter.顺时针和逆时针心房扑动时不同的心房内传导模式。
Circulation. 2001 Sep 4;104(10):1153-7. doi: 10.1161/hc3501.095478.
6
Prospective evaluation of a simplified approach for common atrial flutter radio frequency ablation with only two catheters.仅使用两根导管的常见心房颤动射频消融简化方法的前瞻性评估。
Europace. 2001 Jul;3(3):208-15. doi: 10.1053/eupc.2001.0176.
7
Differential pacing for distinguishing block from persistent conduction through an ablation line.通过差异性起搏区分阻滞与经消融线的持续性传导。
Circulation. 2000 Sep 26;102(13):1517-22. doi: 10.1161/01.cir.102.13.1517.
8
Impact of the ECG for detection of intraatrial conduction block after atrial flutter ablation.心电图对心房扑动消融术后房内传导阻滞检测的影响
Pacing Clin Electrophysiol. 1999 Oct;22(10):1457-65. doi: 10.1111/j.1540-8159.1999.tb00349.x.
9
Quantitative analysis of surface P-wave morphology in isthmus ablation for type 1 atrial flutter: differentiation between complete isthmus block and slow isthmus conduction.1型心房扑动峡部消融术中表面P波形态的定量分析：完全峡部阻滞与峡部缓慢传导的鉴别
Jpn Circ J. 1999 Apr;63(4):244-8. doi: 10.1253/jcj.63.244.
10
Acute and long-term effects of consecutive radiofrequency applications on conduction properties of the subeustachian isthmus in type I atrial flutter.连续射频应用对I型心房扑动中下咽鼓管峡部传导特性的急性和长期影响。
J Cardiovasc Electrophysiol. 1998 Feb;9(2):152-63. doi: 10.1111/j.1540-8167.1998.tb00896.x.

评估体表心电图在典型心房扑动消融后检测峡部传导阻滞的价值。

Evaluation of the surface ECG in detecting isthmus conduction block after ablation of typical atrial flutter.

机构信息

Department of Cardiology, Qianfoshan Hospital of Shandong Province, Jinan, Shandong, China.

出版信息

Clin Cardiol. 2010 Apr;33(4):E11-9. doi: 10.1002/clc.20479.

DOI:10.1002/clc.20479
PMID:20358535
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6653702/
Abstract

OBJECTIVES

To investigate the value of changes in P wave morphology and duration detected by surface electrocardiogram (ECG) during proximal coronary sinus (PCS) and low lateral right atrial (LLRA) stimulation as a marker for complete bidirectional isthmus conduction block in the procedure of typical atrial flutter ablation.

METHODS

Morphology, duration, and ratio of a positive terminal P wave were estimated in 52 typical atrial flutter patients before and after radiofrequency catheter ablation (RFCA).

RESULTS

Atrial flutter ablation resulted in a complete bidirectional isthmus block in all 52 patients. The terminal portion of the P wave towards a positive morphology was detected in 90.7% (47/52) patients both during PCS and LLRA stimulation. These changes were predominantly observed in the inferior leads. Positive morphological changes of the terminal P wave portion and the measured P wave ratio (40% +/- 12%) in the inferior leads indicating bidirectional isthmus conduction block with a sensitivity of 87.5% and a specificity of 91.7% were observed. An increment of 20 ms or more in P wave duration during the PCS stimulation and 10 ms or more during the LLRA stimulation indicating the conduction block with a sensitivity of 90% and a specificity of 100%.

CONCLUSIONS

The variation of P wave morphology and duration in inferior leads of the surface ECG is a helpful technique to assess the complete bidirectional isthmus conduction block in the procedure of typical atrial flutter ablation.

摘要

目的

探讨体表心电图（ECG）在近端冠状窦（PCS）和低位右侧心房（LLRA）刺激过程中 P 波形态和持续时间变化作为典型心房扑动消融过程中完全双向峡部传导阻滞的标志的价值。

方法

在 52 例典型心房扑动患者射频导管消融（RFCA）前后，估计 P 波形态、持续时间和正端 P 波的比值。

结果

52 例患者均行心房扑动消融，达到完全双向峡部阻滞。在 PCS 和 LLRA 刺激时，90.7%（47/52）的患者均检测到正向形态的 P 波终末部分。这些变化主要出现在下导联。下导联终末 P 波正向形态改变和测量的 P 波比值（40% +/- 12%）提示双向峡部传导阻滞，敏感性为 87.5%，特异性为 91.7%。在 PCS 刺激时 P 波持续时间增加 20ms 或更多，在 LLRA 刺激时增加 10ms 或更多，提示传导阻滞，敏感性为 90%，特异性为 100%。

结论

体表心电图下导联 P 波形态和持续时间的变化是评估典型心房扑动消融过程中完全双向峡部传导阻滞的一种有用技术。