Intraoperative Recording of Specialized Atrioventricular Conduction Tissue Electrograms in 47 Patients
Intraoperative Recording of Specialized Atrioventricular Conduction Tissue Electrograms in 47 Patients
复制标题
47 例患者的专业房室传导组织电图术中记录
作者：
M. Dick;W. Norwood;C. Chipman;A. Castañeda
在47例心脏手术患者中进行了术中专门房室传导系统的测绘。37例发现特化传导组织电图，92%保留房室传导。27例房室管缺损发现特化传导组织；25例患者避免了完全心脏传导阻滞。传导组织位于12例复杂转位患者中的6例；6例患者均保留房室传导。其他有用的病变是Ebstein异常和单心房。该技术的局限性是：1)深度低温和循环骤停；2)测图时房室传导中断；3)接触和接触可能的传导组织部位不足；4)个体畸形的大小变化和空间关系；5)对异常位置传导组织的识别时间有限。该技术的适应症包括两种形式的房室管、复杂转位、房室不协调、单心室和单心房的患者。
Intraoperative mapping of the specialized atrioventricular conduction system was performed in 47 patients during cardiac surgery. Specialized conduction tissue electrograms were identified in 37, and atrioventricular conduction preserved in 92%. Specialized conduction tissue was identified in 27 patients with atrioventricular canal defect; complete heart block was avoided in 25. Conduction tissue was located in six of 12 patients with complex transpositions; atrioventricular conduction was preserved in all six. Other lesions in which the technique was useful were Ebstein's anomaly and single atrium. Limitations to the technique are 1) deep hypothermia and circulatory arrest; 2) interruption in atrioventricular conduction during mapping; 3) inadequate exposure and access to probable sites of conduction tissue; 4) variation of size and spatial relations of individual malformations; and 5) limited time for identification of unusually located conduction tissue. Indications for use of this technique include patients with both forms of atrioventricular canal, complex transpositions, atrioventricular discordance, single ventricle and single atrium.