房间隔缺损补片术后多源性房性心动过速的射频消融治疗(附一例报告)

Radiofrequency Catheter Ablation of Multifocal Atrial Tachycardia After Patch Repair of Atrial Septal Defect:A Case Report

报道一例房间隔缺损（ＡＳＤ）补片术后房性心动过速（简称房速）的成功射频消融。电生理检查先后诱发两种房内折返性心动过速。大头消融导管分别在房间隔中上部（补片上方）及前中下部（补片前下方）标测到最早激动Ａ波，在该处成功地进行了射频消融；补片上记录不到明显Ａ波，在此处放电，阻抗突然升高；在补片边缘与心房肌交界处可标测到分裂的Ａ波。随访５个月，未复发。提示射频消融治疗ＡＳＤ补片术后房速有效、安全；认识补片标测特点，对射频消融有一定指导意义。

One patient with multifocal atrial tachycardia after patch repair of atrial septal defect (ASD) underwent radiofrequency catheter ablation (RFCA).Two types of intra atrial reentry tachycardia (IART)were induced during electrophysiologic study.The earliest A waves were mapped by the ablation cathter on the middle upper and the anterior middle inferior parts of the interauricular septum,which were located above the patch and on the anterior inferior of the patch respectively,and then the two kinds of IART were successfully ablated.No A waves were recorded on the patch,when the radiofrequency current was delivered here and the impedance increased abruptly.A splitted A wave could be recorded on the boundary between the margin of the patch and the atrial muscle.This result suggests that RFCA was safe and effective for IART after patch repair of ASD and a clear understanding of the characteristics mapped of the patch might be instructive to RFCA.