摘要目的:探讨心大静脉远端移行区（TAODGCV）阻抗的变化及其对室性心律失常（VA）射频消融术的影响。方法:研究纳入2009年10月至2020年3月在温州医科大学附属第二医院行VA射频消融术，且有效靶点或"最早"激动点在TAODGCV的127例VA患者。根据术中初始应用的消融仪分为2组。①SES组：81例，其中男48例，年龄（56.52±15.60）岁，年龄范围17~82岁；②T11组：46例，其中男28例，年龄（54.92±14.68）岁，年龄范围13~81岁。观察并比较TAODGCV不同部位、生理盐水流速及消融仪阻抗的变化。结果:按心大静脉远端移行区近端（DGCV 1）→心大静脉远端移行区远端（DGCV 2）→前室间静脉（AIV）和左心室顶部穿间隔静脉（Summit-CV）顺序：①初始状态，T11与SES组的阻抗均递增，且T11组均低于SES组，差值40 ~60 Ω[DGCV 1，（207.2±15.3） Ω对（252.9±21.6） Ω；DGCV 2，（242.5±23.8） Ω对（303.7±17.2） Ω；AIV，（268.3±20.6） Ω对（347.1±21.3） Ω；Summit-CV，（264.2±19.6） Ω对（340.3±22.4） Ω；均 P<0.001]；②盐水流速递增时，T11与SES组阻抗均递减，且初始阻抗越高降幅越大；除DGCV 2外，T11组降幅均小于SES组[DGCV 1，18.8 Ω对28.4 Ω；DGCV 2，34.1 Ω对31.6 Ω；AIV，29.9 Ω对44.1 Ω；Summit-CV，35.3 Ω对41.9 Ω；均 P<0.001]。 结论:TAODGCV的部位、初始阻抗、盐水流速和消融仪种类等对阻抗有影响，并存在一定变化规律。

abstractsObjective:To explore the factors influencing impedance in transitional area of distal great cardiac vein (TAODGCV) , and their effect on radiofrequency ablation of ventricular arrhythmia (VA-RFA) .Methods:There were 127 patients with consecutive VA, who underwent VA-RFA in the Second Affiliated Hospital of Wenzhou Medical University from October 2009 to March 2020, and successfully ablated or the earliest exciting site in TAODGCV, were included. Patients were divided into 2 groups.①SES group, 81 patients, 48 men, aged 17-82 (56.52±15.60) years old.②T11 group, 46 patients, 28 men, aged 13-81 (54.92±14.68) years old. Impedance was detected in different sites with different speed and instruments.Results:In the initial status, the impedance increased following DGCV 1→DGCV 2→anterior interventricular vein (AIV) and Summit-CV in both T11 group and SES group, and impedance of T11 group was lower than that of SES group, which differed by 40-60 Ω[DGCV 1, (207.2±15.3) Ω vs. (252.9±21.6) Ω; DGCV 2, (242.5±23.8) Ω vs. (303.7±17.2) Ω; AIV, (268.3±20.6) Ω vs. (347.1±21.3) Ω; Summit-CV, (264.2±19.6) Ω vs. (340.3±22.4) Ω; P<0.001].②The impedance decreased with increasing speed of saline in T11 group and SES group, and the decreasing amplitude of impedance in SES group was greater than in T11 group, except for DGCV 2[DGCV 1, 18.8 Ω vs. 28.4 Ω; DGCV 2, 34.1 Ω vs. 31.6 Ω; AIV, 29.9 Ω vs. 44.1 Ω; Summit-CV, 35.3 Ω vs. 41.9 Ω; P<0.001]. Conclusion:In TAODGCV, impedance is influenced by different sites, initial impedance, speed of saline and ablation instruments, and there is a certain law of change.