室性心动过速起源体表心电图定位.pptVIP

体表心电图与MV起源 Shoei K Stephen Huang,et al.Catheter ablation of Cardiac arrhythmias.Elsevier 2006 起源于二尖瓣环VT部位判断 KOJI KUMAGAI,et al. J Cardiovasc Electrophysiol, Vol. 16, pp. 1029-1036, October 2005 dysdn@经心外膜标测和消融VT Julián Villacastín,et al. Rev Esp Cardiol. 2005;58(1):100-4 小 结 VT or PVC * A右室流出道室间隔，B右室游离壁，C右室近希氏束区，D左室心内膜，E左主动脉窦，F左室心外膜起源于主动脉窦 * * Fig. 1. Localization of VT focus in relation to precordial transition zone in precordial leads. VT with precordial transition zone at V2 or earlier all had an extra-RVOT origin. In half of the patients with precordial transition zone at V3 the origin was localized in the RVOT. When precordial transition zone transition was at V4 or later, RF ablation from the RVOT had high rates of success. * Figure 1. (A) Electrocardiogram of a tachycardia arising from the anterior (leftward) septum. Note the QS complex in lead I, QRS duration of 130, absence of R-wave notching in the inferior leads, and R S in lead V3. (B,C) Electroanatomical maps in the LAO and cranial projections acquired during tachycardia. The color-coded isochrones represent activation times during tachycardia with peak QRS voltage in lead II as the fiducial point. Earliest activation times are shown in red. The brown dots represent ablation sites. Orange dots represent the His bundle. PV = pulmonary valve. * Figure 2. (A) Electrocardiogram of a tachycardia arising from the midposterior (rightward) free wall. Note the slightly positive QRS in lead I, a QRS duration of 160 msec, prominent R-wave notching in the inferior leads, and R S in lead V3. (B,C) Electroanatomical maps in the LAO and cranial projections, respectively, acquired during tachycardia. Format and abbreviations as in Figure 1. * Figure 2. The electrocardiograms of Patients #1 and #2 showing clinical ventricular tachycardias (VTs) originating within the pulmonary artery (PA) (panel I) and the electrocardiogram of Patient #1 showing pace mapping at the successful ablation site within the