首都医科大学附属北京朝阳医院心脏中刘小青.pptVIP

* CASE-1: Geometry of Right Atrium and Aorta Left accessory pathway was diagnosed. We choosed transaortic approach and used the ablation catheter to create the pathway of aorta. The geometry created by NavX system is displayed in a three dimensional way. CASE-1: Aortic Coronary Cusps During the creation of aorta, the three aortic coronary cusps could be seen clearly. So it is important when the ablation catheter across the aortic valves. * CASE-1: Successful Ablation The ablation catheter arrive at the distal CS. The electrogram of catheter has shown the fusion of A and V waves. It is target site. After the first radiofrequency delivery, A and V wave were separated, small A and big V, meant under the mitral valve. Meanwhile the preexcitation of QRS disappeared. A B Figure A : inferior annulus approach, small A and big V on ablation catheter. Inferior and Superior Mitral Annulus Approach (1) Figure B : superior annulus approach, big A and small V on ablation catheter. His RV CS His CS RV Ablation from inferior mitral valve to superior mitral valve. The Green tags meant failure site. The red tag meant the success site. Inferior and Superior Mitral Annulus Approach (2) * CASE-2: AVRT-Right Accessory Pathway Mapping during sinus rhythm, localize the shortest AV conduction or the ventricular insertion site. We moved the catheter around the tricuspid annulus. There are two earlier site, the one is His bundle , the other is the site of accessory pathway . * CASE-2: AVRT-Right Accessory Pathway During RV pacing, mapping the earliest atrial activation site around the tricuspid annulus. * The target site located at 5 o’clock. Almost at the moment of RF delivery (672ms), the preexcitation disappeared. AP was eliminated. CASE-2: Ablation at the Target Site * Preablation CASE-2: Retrograde Atrial Activation Postablation Before ablation, the earliest retrograde atrial activation localized at 5 o’clock. After ablation, the earliest site was located a