经导管射频消蚀治疗阵发性室上性心动过速23例报告

Radiofrequency Catheter Ablation in 23 Cases with Paroxysmal Supraventricular Tachycardia

以射频电能消蚀治疗２３例阵发性室上性心动过速（ＰＳＶＴ）患者。男８例，女１５例；年龄１６～６１岁，平均４３岁。１５例预激综合征中，显性预激７例（Ａ型４例、Ｂ型３例）；隐匿性８例，共１６条旁路，其中左前侧壁３条，左后间隔４条，左侧壁４条，右后间隔４条，右游离壁１条。成功消蚀１５条旁路，其中２条后隔旁路在冠状窦内消蚀成功，１条左后隔旁路未能阻断。７例房室结双径路（ＤＡＶＮＰ）患者采用下位法消蚀，成功地阻断慢径路，不能诱发房室结折返性心动过速（ＡＶＮＲＴ）。１例房内折返性心动过速（ＩＡＲＴ）未能消蚀成功。平均每例放电次数１２±５（６～３２）次，平均输出功率２３．６±４．７（１０～５０）Ｗ，平均累积电能１０７９４±３２４６（２６１５～２０２２５）Ｊ，平均消蚀时程３．０±１．４（１．５～７．５）小时。成功率为９１．３％。本文结果表明经导管射频消蚀治疗ＰＳＶＴ是一项安全、可靠的治疗方法。

Twenty three cases with paroxysmal supraventricular tachycardia(PSVT) were treated by radiofrequency catheter ablation(RFCA).There were 8 men and 15 women with the mean age 43 years(range 16 to 61).Among 15 preexcitation syndrome cases,there were 7 overt (type A 4,type B 3)and 8 concealed preexcitation cases with 16 accessory pathways(APs).After ablation,15 APs were successfully ablated and 2 posteriorseptal APs of them were ablated in caronary sinus.7 patients with atrioventricular nodal reentrant tachycardia (AVNRT) were successfully treated by slow pathway RFCA.1 case with intraatrial reentrant tachycardia was failed in ablation.Success rate was 91 9%.The number and the energy of ablation were mean 12±5 times and 23 6±4 7 walts respectively.We think RFCA is a safe and effective method for PSVT.