心房碎裂电位在房颤消融中的应用演示文稿.pptVIP

心房碎裂电位在房颤消融中的应用;一、What are CFAEs? ;Examples of complex fractionated atrial electrograms;Examples of complex fractionated atrial electrograms;二、碎裂电位的产生机制;碎裂电位形成机制 —— 不同子波叠加进入同一区域;碎裂电位形成机制 —— 标测区出现功能性传导阻滞;碎裂电位形成机制 —— 轴点;碎裂电位形成机制 —— 标测区出现缓慢传导;三、碎裂电位的时间与空间分布稳定性;四、消融碎裂电位的临床报道;Pulmonary Vein IsolationSegmental Approach;Nathan, Circ Res, 1969?;Nathan, Circ Res, 1969?;A New Approach for Catheter Ablation of Atrial Fibrillation: Mapping of the Electrophysiologic Substrate; 病例：121例AF (阵发性57例，持续性64例)， 方法： AF时标测CFE并标记在CARTO三维模型上， 消融CFE，不观察PV电位 消融终点： CFE消失或转为SR，且AF不再被诱发 ;Target Sites for AF Ablation;Target Sites for Atrial Fibrillation Ablation;Regional distribution of CFAEs;RESULTS;CONCLUSIONS;CFE标测图示;FRACTIONATED ELECTROGRAMS (CFEs) IDENTIFIED BY A NOVEL REAL-TIME AUTOMATED MAPPING ALGORITHM ON ATRIAL FIBRILLATION (AF) CYCLE LENGTH, TERMINATION, AND INDUCIBILITY;Baseline vs. Final CFE Map;结 果 CFAE主要分布于房间隔(11)、上肺静脉(9)、顶部(6)及左心耳基底部(5) ;Randomized comparison of encircling and nonencircling left atrial ablation for chronic atrial fibrillation.; 病例：80例慢性AF，随机A、B两组各40例 方法：A组：LACA+post-line+MI B组：3-5 lines in CFE Area: Roof,Anterior,Septal,MI,Post-Annualus 结果： A组：成功率68%，LAFL发生率15% B组：成功率60%，LAFL发生率18% ;Circumferential pulmonary vein ablation (CPVA);Electrogram-guided ablation (EGA);CONCLUSIONS;A Tailored Approach to Catheter Ablation of Paroxysmal AF ;Examples of presence and absence of pulmonary vein tachycardia;Examples of complex electrograms targeted for ablation;An example of tailored ablation;An example of tailored ablation;Ablation strategy;Conclusions;Complex fractionated atrial electrograms represent “local complex activation” or reentry. Complex fractionated atrial electrograms are targets for AF ablation. ; Are complex fractionated atrial electrograms the Rosetta Stone that unlocks