国产心脏射频治疗仪治疗阵发性心动过速

Catheter ablation using radiofrequency current generator made in China for control of paroxysmal tachycardias

报告用我们与西安黄河机器制造厂共同研制的DS92H心脏射频治疗仪,对阵发性心动过速患者47例进行50次射频消融术的结果.前7例次采用美国USCI公司标准电极导管(标准组),无1例成功,其中3例以后改用大头导管.46例采用美国Mansfield公司大头导管(大头组),其中房室结快道消融术(AAVN)10例,房室旁道消融术(AAP)32例(4例左侧游离壁旁道用单大头导管法),室速起源点消融术(AVT)4例.除4例AVT与2例AAP外,均获成功.大头组AAVN与AAP总成功率为95%.成功病例的操作总时间为0.7～5.2(平均2.0)h,且随经验积累,时间缩短.除AAVN1例术后Ⅲ°房室传导阻滞而植入水入起搏器,AAP1例轻度主动脉瓣返流外,无严重并发症.术后随访1～9月(平均5.3月).AAP组3例复发,复发率9.4%;AAVN组无复发.

We reported the results of 50 catheter ablation procedures in 47 patients with paroxysmal tachycar-dias using the DS92H radiofrequency current generator built by us and the Huanghe Machine Building Factory. All the first 7 procedures in 7 patients (standard group) with standard quadripolar catheters (USCI, USA)failed of success and three of the 7 patients underwent a single repeat session with large-tip catheters (Mansfield ,USA) a month later. Of 46 patients (large-up group) for ablation with the large-tip catheters, 10 patients underwent ablation of fast pathway of AV node (AAVN) ,32 patients underwent ablation of accessory pathways (AAP) (Four patients with WPW and a delta wave pattern indicative of an left - sided free -wall accessory pathway under went with the use of just one catheter.) and 4 patients underwent ablation of ventricular tachycardia origin(AVT). In the large-tip group the ablation attempts were unsuccessful in two patients in AAP and four patients in AVT and we had 95% success rate in AAP and AAVN. In the successful cases the session duration was 0. 7~5. 2(mean 2. 0)hours that was shortened by growing experience. There was no serious complication except one patient in AAVN had complete atrioventricu-lar block after ablation and a pacemaker implanted and one patient in AAP had light aortic insufficient after ablation. Over a follow -up period of 1 - 9 (mean 5. 3) months all patients with successful ablation have been free of supraventricular tachycardia but 3 patients in AAP. The recurrence rate was 9. 4 % in AAP and 0 % in AAVN.