射频消融治疗心房扑动

Radiofrequency ablation of typical atrial flutter

目的总结典型心房扑动的射频消融治疗经验。方法56例因反复心悸的住院患者,男性38例,女性18例,平均年龄(54.2±6.2)岁。体表心电图及动态心电图记录阵发心房扑动34例,持续心房扑动22例,口服胺碘酮治疗效果差。全部病例常规取右股静脉途径插入20极环状Halo电极记录心房激动顺序,4极电极送至冠状窦供起搏标测使用。结果全部手术成功。其中36例心房扑动于射频发放过程中终止,20例于窦性心律下放电消融。所有病例于消融结束后分别起搏冠状窦近端和低位右心房,证实峡部双相传导阻滞作为消融终点,即刻成功率100%。平均随访(6±2.6)个月,3例于术后2个月复发,复发率5.4%,经再次射频消融治疗成功,随访6个月,未再复发。结论以温控射频导管不间断放电线性消融治疗典型心房扑动疗效肯定,成功率高。

Objective To summarize the experience of radiofrequency ablation（RF） of typical atrial flutter. Mellaods The study comprised consecutive 56 patients with recurrent palpitation （38 men, 18 women, age 54.2 ± 6.2 years）. In these patients, 34 paroxymal and 22 permanent typical atrial flutter which refractory to amicdarone were documented by E（~ and I-loiter. All patients were inserted a 20 polars Halo lead and a quadripolar electrolead to the right atrial and coronary sinus for mapping and pacing via right femoral vein approach. Results All ablation were success. 36 atrial flutter were ter- minated during RF, and 20 cases were given ablation in sinus rhythm. After RF, pace the proximal of CS and the low right atrial separately in order to demonstrate the complete bidirectional isthmus block. The acute success rate was 100%. 3 recurrence of typical atrial flutter（5.4% ） during a mean follow- up period 6±2.6 months. These patients underwent a successful reperablation procedure. Conclusion RF ablation by using temperature control catheter is a highly effective and safe procedure in treatment of typical atrial flutter.