主动脉右心房压迹致频发房性早搏一例

doi:10.11958/20251486

天津医药 ›› 2025, Vol. 53 ›› Issue (11): 1219-1222.doi: 10.11958/20251486

主动脉右心房压迹致频发房性早搏一例

张恩圆(), 何乐, 张赫男, 卢凤民^△()

天津大学胸科医院心内五科（邮编 300222）

收稿日期:2025-04-09 修回日期:2025-07-30 出版日期:2025-11-15 发布日期:2025-11-19
通讯作者: △E-mail：drlfm79@sina.com
作者简介:张恩圆（1989），男，主治医师，主要从事心律失常的诊疗及房颤与影像学的融合方面研究。E-mail：doctorenyuan@126.com
基金资助:
天津市卫生健康科技项目(TJWJ2022QN068);天津市医学重点建设学科项目(专科TJYXZDXK-3-017B)

A case of frequent premature atrial complexes secondary to aortic compression of the right atrium

ZHANG Enyuan(), HE Le, ZHANG He’nan, LU Fengmin^△()

Department of 5^th Cardiology, Tianjin University Chest Hospital, Tianjin 300222, China

Received:2025-04-09 Revised:2025-07-30 Published:2025-11-15 Online:2025-11-19
Contact: △E-mail：drlfm79@sina.com

张恩圆, 何乐, 张赫男, 卢凤民. 主动脉右心房压迹致频发房性早搏一例[J]. 天津医药, 2025, 53(11): 1219-1222.

ZHANG Enyuan, HE Le, ZHANG He’nan, LU Fengmin. A case of frequent premature atrial complexes secondary to aortic compression of the right atrium[J]. Tianjin Medical Journal, 2025, 53(11): 1219-1222.

摘要/Abstract

摘要：

1例78岁男性患者因主动脉无冠窦显著扩张压迫右心房，形成局部低电压区，引发频发多形性房性早搏（24 h负荷40.9%）。通过双房联合激动标测锁定靶点（右心耳-三尖瓣环连接处），经射频消融后房性早搏消失，随访半年无复发。目前心房受压相关房性心律失常的病因较多，但明确累及右心房并导致孤立性频发房性早搏十分罕见。治疗需个体化选择介入或外科手术，并重视多模态影像（超声、CT血管造影、三维电解剖系统）对解剖-电学关联的解析。

关键词: 心房早搏复合征, 放射摄影影像解释, 计算机辅助, 主动脉瓣狭窄

Abstract:

A 78-year-old male patient presented with significant dilation of the non-coronary sinus of the aorta, which compressed the right atrium and formed a local low-voltage area, resulting in frequent polymorphic atrial premature beats (24-hour load 40.9%). Through dual-chamber combined activation mapping, the target point (right atrial appendage - tricuspid valve annulus junction) was locked. After radiofrequency ablation, atrial premature beats disappeared, and there was no recurrence during the follow-up period of six months. Currently, there are many causes of atrial arrhythmias related to atrial compression, but it is extremely rare for the right atrium to be involved and cause isolated frequent atrial premature beats. Treatment should be individualized, choosing either interventional or surgical methods, and emphasizing the interpretation of anatomical-electrical correlations using multimodal imaging (ultrasound, CT angiography, three-dimensional electroanatomical system).

Key words: atrial premature complexes, radiographic image interpretation, computer-assisted, aortic valve stenosis

中图分类号:

R541.7

图/表 4

图1 房早时的体表心电图

Fig.1 Surface electrocardiogram during premature atrial contractions

图2 CTA逐层扫描图像 A：左冠窦及左主干；B：无冠窦显著凸向右房；C：左室流出道-主动脉窦部连接处；D：右冠窦及右冠；E：主动脉右房压迹CTA冠状面；F：主动脉右房压迹CTA矢状面。

Fig.2 CTA scan images layer-by-layer

图3 房早标测时的电解剖三维图 A：房早最早激动点与HIS存在一定距离；B：房早时左房标测，房间隔激动最早；C：双房标测提示房早起源于右心耳与三尖瓣环顶点连接处。

Fig.3 Electroanatomical 3D map during atrial premature mapping

图4 房早时腔内图

Fig.4 Intracavitary electrogram during premature atrial contractions

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主动脉右心房压迹致频发房性早搏一例

A case of frequent premature atrial complexes secondary to aortic compression of the right atrium

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