射频消融右侧房室旁束的经验

Experience of radio frequency ablation with right atrio-ventricular pathway

射频消融右侧房室旁束１５例，其中显性旁束１０例，隐匿性旁束５例。后者根据电生理检查进一步确定旁束位置。显性旁束可根据常规心电图的预测主波方向作出旁束的大概定位。采用左前斜位３０°透视，以心腔内心电图及心导管的活动情况定位粗标三尖瓣环的位置，以三尖瓣环为时钟，根据大概定位细标大头电极导管，找到最短的Ａ－Ｖ和Ｖ－Ａ间期或ＡＶ完全融合处进行射频消融。

Radio frequency(RFI ablation was made in 15 patients with right accessorypathway , 10 were apparent pathway , 5 were concealed accessory pathway. The latter were furthermapped with EPS,and apparent pathways were localized by ECG main wave direction. Tricuspidvalve ring mapping was performed under LAO 30' according to intracardiac ECG and cardiaccatheter movement. RF ablation was performed at the shortest A-V and V-A interval or complerefusion of AV around tricuspid valve clockwisely.