射频消融治疗房室折返性心动过速16例分析

The Analysis of 16 Patients With Atrioventricular Reentrant Tachycardia by RFCA

目的:房室折返性心动过速(AVRT)是临床实践中常见的心律失常,本文报道对其进行标测及射频导管消融(RFCA)的经验。方法:16例患者(男性9例,女性7例),平均年龄(40.1±10.7)岁,对全部患者进行了心内电生理检查,在标测到的逆行心房最早激动部位进行射频导管消融。结果:16例患者中,11例为隐匿性左侧旁路,1例为隐匿性右后间隔旁路,4例为B型预激综合征。隐匿性左侧旁路中,左后间隔旁路3例,左前旁路5例,左后旁路3例。B型预激综合征中3例为右前游离壁旁路,1例为右后游离壁旁路。B型预激综合征右前游离壁旁路影像学有效消融靶点为:左前斜位45°,右房室环9点处。右后游离壁旁路影像学有效消融靶点为:左前斜位45°,右房室环7点处。所有患者均获得成功,无并发症。结论:RFCA术治疗AVRT有效、安全。

Objective： Atrioventricular reentrant tachycardia（AVRT） is the clinically common arrhythymia. We reported the experiences of radiofrequence catheter ablation（RFCA）. Methods： Sixteen patients（9male, 7female） ,average aged 40.1 ±10.7 years,were enrolled in electrophysiologic study. Ablation were adapted in retrograde early atrial activity point. Results：Of sixteen patients, eleven patients were latent left side accessory pathways,one patient was latent right side accessory pathway and four patients were B style W-P-W syndrome. Three patients were in left posterial septal accessory pathways, five patients in left anterial accessory pathways and three patients in left posterial accessory pathways. One patient were in right poster]al septal accessory pathway, Three patients with Bstyle W-P-W syndrome were in right anterial free wall accessory pathways, One patient with B style W-P-W syndrome were in right posterial free wall. It＇s effetive ablation targetis：right anterial free wall accessory pathway was in left anterial oblique 45°, right atrial ventricular annular 9 O＇clock. Right posterial free wall accessory pathway was in left anterial oblique 45° ,right atrial ventricular annular 7 O＇ clock. All patients were succeeded and no complication. Conclusions： RFCA is safe and effective for PSVT.