心室解剖与电生理专业知识宣讲培训课件

心脏大血管方向1流出道解剖RVOTLVOT2右室流出道结构示意图34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

1112肺动脉瓣上下起源的

室速鉴别13HiroshiTada,etal:HeartRhythm2008;5:419–42614HiroshiTada,etal:HeartRhythm2008;5:419–4261516RVOT与冠状动脉窦位置关系RCCRCCLCCLCC17LVOT与RVOT关系18LVOT/RVOT的关系JCE,Vol.20,pp.955-968,August2009192021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3031ProximitytoLeftMain32LVOT的标测33RVOTandAorticCusps34流出道室速：12导联V1形态35流出道室速：12导联V1形态36AorticCusps37AorticCusps38AorticCusps39VTOriginatedfromAorticSinusCuspsASCASCRVOTRVOT40JCardiovascElectrophysiol,Vol.20,pp.955-968,August2009V1ECGforDifferentiationofOutflowVT41ComparisonofLVOTvs.RVOTandPALVOTRVOTPAPARAOLAOLVOT/RVOT的关系42左室流出道消融导管操作434445VTOriginatedfromCoronaryCuspsOuyangF,etal.JACCCardiol2002;39:500–846RAOAblationCatheterattheLeftCoronaryCuspABLRAO47LeftCoronaryCuspRAOLAO48LeftCoronaryCusp4950RightCoronaryCuspRAOLAO51RightCoronaryCuspRAOLAO52HISRAOLAO5354LVOT-AortoMitralContinuity55AblationatAMC56IIIIIIaVRaVLaVFV1V6AbdAbpAI-GCVdAI-GCVpRVOT51RAOLAOLCCLVOT-AortoMitralContinuityRAO57LVOTArrhythmiasAnatomyoftheLVOTLVOTArrhythmiasRCCLCCRCC/LCCJunctionLVOT-AortoMitralContinuityAIV-GCV

EKGMappingAblation581-EpicardialApproach-nothelpful2-Mappingandablationfrom:a.LCCb.LVendocardium(belowLCC)c.AIV-GCVjunctionLMLADCxAIVLAAAORVOT59GCV-AIVjunctionCatheterPulledBackICNitro60616263646566Mapping

ofVTfromCardiacVeinandEpicardiumRAO35

LAO35CaudalViewMappingCatheterviaSubxiphoidPuncture67ThankYou.6869F/18,PalpitationandSyncope70CSvenogramF/18,PalpitationandSyncope716FrAblcatheterwithinAIVF/18,PalpitationandSyncope72ActivationMap:-54msbeforeQRSwithinGCV-AIVjunction73IIIIIIaVRaVLaVFV1V2V3V4V5V6ActivationMapping&PaceMapping-54ms74CoronaryAngiogramPr