作者：马彦卓，杨茜，陈瑜，宋新星，李洁，梁卓，唐丽娜，齐书英

单位：

1.050082河北省石家庄市，中国人民解放军联勤保障部队第九八〇医院心内科 2.100029北京市，首都医科大学附属北京安贞医院心内科 通信作者：齐书英，E-mail：qsy304@126.com

Units：

1.Department of Cardiology, Bethune International Peace Hospital of PLA, Shijiazhuang 050082, China 2.Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China Corresponding author: QI Shuying, E-mail: qsy304@126.com

关键词：

持续性心房颤动; 射频导管消融术; Marshall静脉; 上腔静脉;

Keywords：

Persistent atrial fibrillation; Radiofrequency catheter ablation; Vein of Marshall; Superior vena cava

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.088

Funds：

河北省医学科学研究重点课题（20210200）

摘要：

持续性心房颤动(以下简称房颤)常需要在环肺静脉电隔离(PVI)的基础上增加肺静脉外触发灶的消融,包括线性消融、BOX消融及碎裂电位消融等。二尖瓣峡部是线性消融最重要的组成部分,但是传统射频消融很难达到二尖瓣峡部的彻底阻滞。经下腔静脉送入指引导管至冠状静脉窦,注入Marshall静脉无水乙醇消融可实现二尖瓣峡部心外膜和心肌阻滞,联合二尖瓣峡部心内膜补点消融能明显提高房颤患者二尖瓣峡部隔离效果。本文主要报道1例经PVI+BOX消融后复发的持续性房颤患者,经上腔静脉行Marshall静脉无水乙醇消融联合个体化消融策略,出院后随访2周,无房颤复发和主要不良心血管事件发生。

Abstract：

【Abstract】 The ablation of trigger focus outside pulmonary vein is often required for patients with persistent atrialfibrillation on the basis of pulmonary vein isolation (PVI) , including linear ablation, BOX ablation and fragmentation potentialablation. Mitral isthmus is the most important part of linear ablation, but traditional radiofrequency ablation is difficult to achievecomplete block of mitral isthmus. The guiding catheter was sent to the coronary sinus through the inferior vena cava and injectedinto absolute ethanol ablation for Marshall vein, and combined with radiofrequency ablation targeting the endocardial in mitralisthmus, can significantly improve the isolation effect of mitral isthmus in patients with atrial fibrillation. This paper mainly reportsa patient with recurrent persistent atrial fibrillation after PVI+BOX ablation, who underwent ethanol ablation of Marshall veinthrough superior vena cava combined with individualized ablation strategy, and was followed up for 2 weeks after discharge. Therewas no recurrence of atrial fibrillation and major adverse cardiovascular events.

ReferenceList：