房颤消融冠状窦内放电的依据江洪.ppt

* 房颤消融：冠状窦内放电的依据 江 洪 武汉大学人民医院 2. AF Trigger from CS 3. Prominent CFAE in CS - CS隔离 4. AT/AF Mitral isthmus ablation in CS 1.冠状窦的特殊结构 5. 冠状窦内放电的能量选择和安全性 CS Myocardial Coat Great Cardiac Vein Middle Cardiac Vein Posterior Coronary Vein IVC LA CS Myocardial Coat Conducts Activation From LA to Triangle of Koch 2. AF Trigger from CS 3. Prominent CFAE in CS - CS隔离 4. AT/AF Mitral isthmus ablation in CS 1.冠状窦的特殊结构 5. 冠状窦内放电的能量选择和安全性 AT/AF Trigger from CS CS AT/AF Trigger from CS -49ms RF on Ablation Catheter CS AT/AF Trigger from CS Isolation of CS endocardially and epicardially AT/AF Trigger from CS Before ablation After ablation 2. AF Trigger from CS 3. Prominent CFAE in CS – CS isolation 4. AT/AF Mitral isthmus ablation in CS 1.冠状窦的特殊结构 5. 冠状窦内放电的能量选择和安全性 CFAE Ablation CFAE消融 CFAE in CS Ablation CFAE in CS Ablation CFAE in CS 见下面的附注 Before ablation After ablation 2. AF Trigger from CS 3. Prominent CFAE in CS – CS isolation 4. AT/AF Mitral isthmus ablation in CS 1.冠状窦的特殊结构 5. 冠状窦内放电的能量选择和安全性 房颤手术时常常需要消融二尖瓣峡部 Activation MAP AP Projection Mitral Annulus 1.0 cm RSPV RIPV LSPV 100 ms -100 ms AT (CL 200 ms) 6 Months Post PV Isolation 二尖瓣峡部依赖性房速 2. AF Trigger from CS 3. Prominent CFAE in CS – CS isolation 4. AT/AF Mitral isthmus ablation in CS 1.冠状窦的特殊结构 5. 冠状窦内放电的能量选择和安全性 *