射频消蚀术治疗房性心动过速

Radiofrequency catheter ablation of atrial tachycardia

５例房性心动过速（房速）行射频消蚀术，男２例，女３例，平均年龄４９岁。方法是用二根大头消蚀导管标测心房，在初定房速部位交替、移动标测，Ａ波出现最早处射频放电。结果：５例均为右房房速，２例为自律性房速，３例为房内折返性心动过速。射频消蚀的靶点，２例在冠状窦口上方，１例在冠状窦口下方，１例在右房中侧壁，１例在上侧壁，靶点处Ｐ－Ａ为－２５～－４０ｍｓ；５例射频消蚀全部成功，随访１～８个月无１例复发。初步认为，射频消蚀术治疗房速既有效又安全。

Abstract Five patients (pts) with atrial tachycardia (AT), 2males, 3 females, with a mean age of 49 years, underwent radiofrequency catheter ablation (RFCA). Two deflectable tip catheters were moved alternately in order to find the earliest site of atrial activation, at which radiofrequency energy was delivered.Results:Right atrial tachycardia in the five pts was verified by electrophysiological mapping. The causes of AT were automaticity in two pts and intra-artial reentry in 3. The target sites of ablation located at the superior coronary sinus (CS) ostium (two pts), inferior CS ostium (one pt),mid-lateral wall (one pt), and upperlateral wall (one pt). P-A at the target site was-25 to -40ms. Radiofrequency energy successfully eliminated the 5 atrial foci without recurrence in a follow up period of 1 to 8 months.The results suggest that radiofrequency ablation energy delivered to the earliest site of atrial activation in AT is both safe and effective. The method by using two deflectable tip catheters is a practical mapping technique for AT.