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目的:探讨冠状静脉窦(冠状窦,coronarysinus,CS)腔内电图与局部肌袖电位的关系。方法:室上性心动过速行射频消融术的患者42例。窦性心律下,于冠状窦近端发放递减刺激。观察冠状窦A波激动顺序、波形变化、双电位的有无、冠状窦激动时间。结果:窦性心律时67%的患者的冠状窦远端A波为先正向后负向,波形较宽,成分多。递减刺激首先夺获窦口的A波,使之提前,激动方向改变为先负向后正向。但此时冠状窦远端的A波形态不变、不提前。随刺激的逐渐提前,冠状窦中段、远段的A波提前,且波形改变。窦性心律时,冠状窦激动时间为(24.37±9.41)ms。刺激完全夺获冠状窦时,冠状窦激动时间为(34.62±10.40)ms。两者有非常显著的差异。结论:冠状窦A波不是单纯的心房波,而是肌袖电位和左心房电位的融合波。
Objective: To investigate the relationship between intracavitary electrical potential and local muscular sleeve potential of coronary sinus (coronary sinus, coronarysinus, CS). Methods: Forty-two patients with supraventricular tachycardia underwent radiofrequency catheter ablation. Sinus rhythm, distributed in the proximal coronary sinus decreased stimulation. A wave of coronary sinus activation sequence, waveform changes, bipotential presence, coronary sinus activation time. Results: In 67% of patients with sinus rhythm, the distal A wave of coronary sinus was first positive and then negative, with a wide waveform and multiple components. Decreasing stimulation first seizes the A wave of the ostium so as to advance it in advance and change the direction of the excitement to be negative first and then positive. But this time the A wave of the distal coronary sinus constant shape, not in advance. With the gradual advance of stimulation, the middle and distal coronary sinus A wave advance, and the waveform changes. Sinus rhythm, coronary sinus activation time was (24.37 ± 9.41) ms. When stimulating the coronary sinus completely, the time of coronary sinus activation was (34.62 ± 10.40) ms. There are very significant differences between the two. Conclusion: A wave of coronary sinus is not a simple atrial wave, but a fusion wave of muscular sleeve potential and left atrial potential.