双大头电极间放电成功消融后间隔旁道(附一例报告)

Radiofrequency Catheter Ablation of Posteroseptal Accessory Atrioventricular Pathway by Discharge Between A Tricuspid Annulus Electrode and A Mitral Annulus Electrode: Report of One Case

报道１例采用在双大头电极之间放电成功消融后间隔旁道的病例。该例有心动过速病史８年，特殊检查未见心脏结构异常。心电图示显性Ｂ型预激。心内标测为连接左房与右室的后间隔旁道。采用常规单大头电极分别在三尖瓣环右房侧、二尖瓣环左室侧及左房侧反复放电均未成功。改用与单大头电极放电相同位置的三尖瓣环右房侧与二尖瓣环左室侧的双大头电极之间放电，功率１５Ｗ、阻抗９８Ω，放电３ｓ后ｄｅｌｔａ波消失，巩固放电至９９ｓ而获得成功。此例说明。

One case of successful ablation of posteroseptal accessory atrioventricular pathway by discharge between a tricuspid annulus electrode and a mitral annulus electrode was reported.The electrocardiogram showed the Wolff Parkinson White syndrome of B type.The result of intracardiac mapping was a posteroseptal accessory atrioventricular pathway between the left atrium and the right ventricles.Unipolar current discharges were unsuccessful at the right atrial side of tricuspid annulus or at the left ventricular side or left atrial side of mitral annulus,while bipolar discharges were successful at the right atrial side of tricuspid annulus and at the left ventricular side of mitral annulus.The ablation power was 15 W and resistance 98 Ω,discharge time 99 s(disappearance of delta wave in 3 s).The result shows success rate in radiofrequency catheter ablation of posteroseptal accessory pathways will be higher than that by unipolar discharge only.