射频消融术及心内电生理检查发生误诊的原因分析(附5例报告)

An Analysis of Misdiagnosis in the Electrophysiologic Study and Radiofrequency Catheter Ablation

对5例病人射频消融及心内电生检查中误诊的原因进行分析。术前诊断房性心动过速(简称房速)3例,房室折返性心动过速2例。心内电生理检查与射频消融术一次完成。结果:3例术前诊断为房速者,术后证实为左侧壁慢旁道、左后壁慢旁道以及左侧壁旁道参与的房室折返性心动过速各1例;2例术前诊断为房室折返性心动过速者,术后证实为房室结折返性心动过速、房速各1例,分别行慢径消融及房室结改良。5例病人射频消融治疗均成功。结论:未进行详细的心内电生理检查及术前诊断的误导是造成消融术中误诊的主要原因。

The purpose of this paper is to analyze the reasons of misdiagnosis in patients who accepted radiofre- quency catheter ablation (RFCA) and electrophysiologic studies (EPS).Material and method:Five patients who suffered from the reciprocated tachycardia for several years were involved in.Three patients were diagnosised as a- tria tachycardia and two patients as atrioventricular reentrant tachycardia before the operation.The EPS and RFCA were carried out at the same session.Result:EPS and RFCA confirmed that the tachycardias were caused by slow conductive accessory pathways in two patients and by atrioventricular accessory pathway in one patient who was misdiagnosis atrial tachycardia before operation.While the other two pateints who were diagnosised as atrioven- tricular reentrant tachycardias before the procedure were proved to be atrioventricular nodal reentrant tachycardia and atrial tachycardia respectively.All patients were abolished satisfactorily.Conclusion:Simple electrophysiologic study and misleadingness by the pre-procedure diagnosis are the main reasons of misdiagnosis.