Abstract:
Premature ventricular contraction (PVC) is usually eliminated in the earliest activation site based on the conventional electrode of ablation catheter. However, the large size electrode may contain far-field potential. The QDOT MICRO ablation catheter has three micro electrodes with 0.33 mm electrode length, in addition to the conventional electrode with 3.5 mm electrode length. The micro electrodes can reflect only near-field potential. A 78-year-old with symptomatic frequent PVCs underwent catheter ablation. PVC-1 showed good pace-mapping in distal great cardiac vein (GCV). The local bipolar electrograms in the conventional electrode of ablation catheter preceded the PVC-QRS onset by 32 ms in distal GCV and 13 ms in left coronary cusp (LCC), but those in the micro electrodes preceded only by 13 ms both in distal GCV and LCC. PVC-1 was eliminated by radiofrequency (RF) application, not in distal GCV, but in LCC. PVC-2 showed good pace-mapping in LCC. The local bipolar electrograms in both the conventional electrode and the micro electrodes of ablation catheter preceded the PVC-QRS onset by 32 ms in LCC. PVC-2 was eliminated by RF application in LCC. Comparing the local electrograms of micro electrodes and the conventional electrodes may be important for identifying depth of the origin of PVCs.
摘要:
基于消融导管的常规电极,通常在最早的激活部位消除过早的心室收缩(PVC)。然而,大尺寸电极可以包含远场电位。QDOTMICRO消融导管有三个微电极,电极长度为0.33mm,除了常规电极与3.5毫米电极长度。微电极只能反射近场电势。一名78岁有症状的频繁PVCs患者接受了导管消融。PVC-1在远端大心静脉(GCV)中显示出良好的步速定位。消融导管常规电极中的局部双极电描记图在远端GCV和左冠状尖点(LCC)分别比PVC-QRS发作早32ms和13ms,但是在远端GCV和LCC中,微电极中的那些仅在13ms之前。PVC-1通过射频(RF)应用消除,不在远端GCV,但在LCC。PVC-2在LCC中表现出良好的速度映射。在LCC中,常规电极和消融导管的微电极中的局部双极电描记图均比PVC-QRS发作早32ms。在LCC中通过RF应用消除了PVC-2。比较微电极和常规电极的局部电描记图对于识别PVC起源的深度可能是重要的。