射频消蚀治疗预激综合征81例报告

Catheter Ablation of Atrioventricular Accessory Pathway With Radiofrequency Current

以射频电流对81例预激综合征伴阵发性室上性心动过速患者的房室旁路进行消蚀。76例(93.8％)患者的83条旁路(94.3％)被阻断。平均放电12次,平均消蚀时程2.3小时,随访7个月,2例(2.5％)复发但成功地进行第二次消蚀,无严重并发症。

Eighty-one patients with atrioventricular accessory pathway mediated tachyarrhythmias were ablated with radiofrequency current in the study. There were 88 accessory pathways including left free wall 59.left posterolateral 8. left posteroseptal 5.right anteroseptal 4,right posteroseptal 5 and right free wall 7. In patients with left-sided accessory pathway,a large-tip ablation catheter were positioned in the left ventricular side of mitral annulus. In patients with right side accessory pathway,the ablation catheter was placed on the coronary sinus ostium(right posteroseptal),just above the His bundle area(right anteroseptal) or atrial aspect of tricuspid annulus(right free wall). Eight-three accessory pathways(94. 3%) in 76 patients(93. 8%) were abolished permanently after the first session. The mean applications was 12±7(1～60) times and accumulated energy was 1 4000J.The mean ablation period was 2. 3±0. 8(0. 3～6. 0) hours. Two patients recurred(2. 5%) after mean 7 months follow-up and be ablated successfully again. One patient experienced left femoral veneous thrombosis one week after ablation and relieved by urokinas infusion. No other serious complications were encountered. We concluded that radiofrequency current ablation of accessory pathways is an safe and effective modality.