Nogami A, Suguta M, Tomita T, Naito S, Taniguchi K, Aonuma K, Iesaka Y
Cardiology Division, Gunma Prefectural Cardiovascular Center, Japan.
Pacing Clin Electrophysiol. 1998 Dec;21(12):2691-4. doi: 10.1111/j.1540-8159.1998.tb00051.x.
We report two patients with reentrant atrial tachycardia that originated at the AV annulus. Atrial tachycardia originated in the posterior portion of mitral annulus in one patient (case 1) and the posterolateral portion of tricuspid annulus in one patient (case 2). Tachycardia was successfully eliminated by RF catheter ablation in both patients, with the catheter placed underneath the mitral valve in case 1 and on the tricuspid annulus in case 2. Spiky potentials were recorded in the diastolic phase of the atrium during tachycardia at the sites of successful ablation. Spiky potentials were also recorded after atrial electrogram during sinus rhythm, and showed decremental properties during atrial pacing. An accelerated atrial rhythm was observed during RF application, and tachycardia could not be induced after ablation in either patient. Tachycardia in these patients seemed to be due to reentrant tachycardia originating in the accessory AV node (Mahaim fiber) without ventricular connection.
我们报告了两例起源于房室环的折返性房性心动过速患者。一例患者（病例1）房性心动过速起源于二尖瓣环后部，另一例患者（病例2）起源于三尖瓣环后外侧部。两名患者均通过射频导管消融成功消除了心动过速，病例1将导管置于二尖瓣下方，病例2置于三尖瓣环上。在心动过速期间，成功消融部位的心房舒张期记录到尖锐电位。窦性心律时心房电图后也记录到尖锐电位，且在心房起搏时表现出递减特性。射频应用期间观察到心房节律加速，消融后两例患者均未诱发心动过速。这些患者的心动过速似乎是由于起源于无室连接的房室旁道（Mahaim纤维）的折返性心动过速所致。
