单导管法射频消融左游离壁旁道32例

Radiofrequency current ablation of left free wall accessory atrioven-tricular pathway in Wolff-parkinson-White syndrome by singlelarge-tip electrode catheter

３２例左游离壁旁道采用单导管法射频消融成功．其中Ａ型预激综合征２９例，隐匿性左侧旁道３例，均为单旁道．２５条旁道位于左侧壁，７条位于左后壁．本组单导管法平均放电次数为３．５±３．２次，操作总时间１．１±０．６ｈ，Ｘ光曝光时间１３±５．５ｍｉｎ，都短于我们的多导管法．术后随访１～１３月，仅１例于术后４日δ波复现，再次用此法成功，余均无复发．单导管法仅适用于Ａ型预激综合征，且术者应有多导管法的丰富经验．但其大头导管的“窦－室－窦”标测法却普遍适用于任何旁道的消融，熟悉此方法，将会使任何旁道的消融缩短时间，提高成功率．

Thirty-two left free wall accessory atrioventricular pathways of 32 patients with Wolff-parkinson-White syndrome(WPW)were successfully abolished by single large-tip electrode catheter ablation(SCA). Of 32 patients,29 were with A-type WPW,3 with conceal left accessory atrioventricular pathway. Twenty-five and 7 of 32 pathways were located in left lateral wall and left posterior wall,respectively.A mean of 3. 5±3.2 applications of radiofrequency current were delivered,the procedure time(1.1±0.6 h)and radiation exposure time(13±5.5 min)in SCA were significantly shorter than those in our multiple electrode catheter ablation.During a follow-up of 1～13 months,δ wave of 1 patient recurred after 4 d of ablation and was e-liminated by a second SCA. The other patients had no recurrence of atrioventricular reentry tachycardia.SCA was only suitable for A-type WPW.However,the principle of locating accessory pathways in SCA would be universally applicable in radiofrequency current ablation(RFCA) of all accessory atrioventricular pathways.Moreover, this principle could also shorten the procedure time and increase the success rate of RFCA.