心室解剖与电生理专业知识宣讲培训.ppt

心脏大血管方向1

流出道解剖RVOTLVOT2

右室流出道结构示意图3

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右室流出道解剖：瓣下5

右室流出道解剖：瓣下6

右室流出道解剖：瓣上7

右室流出道解剖：肺动脉主干8

右室流出道解剖：瓣上9

右室流出道解剖：瓣上10

放置SR0及消融导管SR0

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肺动脉瓣上下起源的

室速鉴别13

HiroshiTada,etal:HeartRhythm2008;5:419–42614

HiroshiTada,etal:HeartRhythm2008;5:419–42615

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RVOT与冠状动脉窦位置关系RCCRCCLCCLCC17

LVOT与RVOT关系18

LVOT/RVOT的关系JCE,Vol.20,pp.955-968,August200919

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左室流出道解剖：瓣上22

左室流出道解剖：瓣上23

左室流出道解剖：瓣上24

左室流出道解剖：瓣上

——冠状动脉开口25

左室流出道解剖：瓣上

——主动脉瓣关闭运动26

左室流出道解剖：瓣上

——主动脉瓣关闭运动27

左室流出道解剖：瓣下28

左室流出道解剖：瓣下29

左室流出道解剖：瓣下30

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ProximitytoLeftMain32

LVOT的标测33

RVOTandAorticCusps34

流出道室速：12导联V1形态35

流出道室速：12导联V1形态36

AorticCusps37

AorticCusps38

AorticCusps39

VTOriginatedfromAorticSinusCuspsASCASCRVOTRVOT40

JCardiovascElectrophysiol,Vol.20,pp.955-968,August2009V1ECGforDifferentiationofOutflowVT41

ComparisonofLVOTvs.RVOTandPALVOTRVOTPAPARAOLAOLVOT/RVOT的关系42

左室流出道消融导管操作43

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VTOriginatedfromCoronaryCuspsOuyangF,etal.JACCCardiol2002;39:500–846

RAOAblationCatheterattheLeftCoronaryCuspABLRAO47

LeftCoronaryCuspRAOLAO48

LeftCoronaryCusp49

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RightCoronaryCuspRAOLAO51

RightCoronaryCuspRAOLAO52

HISRAOLAO53

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LVOT-AortoMitralContinuity55

AblationatAMC56

IIIIIIaVRaVLaVFV1V6AbdAbpAI-GCVdAI-GCVpRVOT51RAOLAOLCCLVOT-AortoMitralContinuityRAO57

LVOTArrhythmiasAnatomyoftheLVOTLVOTArrhythmiasRCCLCCRCC/LCCJunctionLVOT-AortoMitralContinuityAIV-GCVEKGMappingAblation58

1-EpicardialApproach-nothelpful2-Mappingandablationfrom:a.LCCb.LVendocardium(belowLCC)c.AIV-GCVjunctionLMLADCxAIVLAAAORVOT59

GCV-AIVjunctionCatheterPulledBackICNitro60

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MappingofVTfromCardiacVeinandEpicardiumRAO35?LAO35?CaudalViewMappingCatheterviaSubxiphoidPuncture67

ThankYou.68

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F/18,PalpitationandSyncope70

CSvenogramF/18,PalpitationandSyncope71

6FrAblcatheterwit