多房室旁道的射频消融治疗

Radiofrequency Catheter Ablation of Multiple Atrioventricular Accessory Pathways

目的对多房室旁道的电生理特点及射频消融方法进行探讨。方法预激综合征伴房室折返性心动过速患者１６例，其中心电图呈显性预激综合征１２例，正常４例。治疗采用先消融显性旁道，后消融隐匿性旁道的方法。结果本组１６例患者，共３３条旁道，其中双旁道１５例，三旁道１例。消融阻断所有旁道，成功率１００％。结论多房室旁道大多数是在心腔电生理检查和消融术中被诊断，心电图可提供某些诊断线索。逐条消融旁道是避免漏诊的可靠方法。

Objective\ The purpose of this paper is to discuss the characteristics of electrophysiology and the method of ablation of multiple atrioventricular accesary pathways.\ Methods\ This study included 16 patients, the ECG showed 12 patients with manifest pathways and 4 patients with concealed pathways. The manifest accessory pathways were ablated one by one, and then the concealed accessory pathways.\ Results\ There were 33 pathways in all this group of patients(double pathways in 15,triple pathways in 1). \ All of these pathways were successfully ablated without complications occurred.\ Conclusion\ Radiofrequency catheter ablation appears to be a safe and effective method for the management of atrioventricular reentry tachycardia caused by multiple atrioventricular accessory pathways.\ Most of these multiple pathways could be found during the electrophysiological study and catheter ablation.\ The ECG could give some hints of multiple pathways before the procedure.