射频消融治疗局灶性心房颤动初步结果

Radiofrequency catheter ablation of focal atrial fibrillation originating from left supperior pulmonary vein

目的 评价射频消融治疗由房性早搏 (房早 )诱发的局灶性心房颤动 (房颤 )的安全性和可靠性 ,并探讨有关射频消融治疗中一些方法学问题。 方法 1例 44岁女性患者 ,阵发房颤 4年余 ,心电图证实房颤由房早诱发 ,药物治疗无效 ,行射频消融治疗。放置常规电生理检查导管和 Halo导管 ,穿刺房间隔 ,大头导管经房间隔在左房内肺静脉进行标测 ,在左上肺静脉内标测到诱发房颤的房早时最早心房激动 ,放电消融 3次 ,房早、房颤消失。结果 随访两周后有房早和短阵房颤发生 3次 ,术后两周至 6个月未服用药物 ,无房颤发生。结论 射频消融可能成为治疗局灶性房颤一种安全有效的方法。

Objective To investigate the safety and efficacy of using radifrequency catheter ablation for focal atrial fibrillation(AF)arising from pulmonary veins(PVs). Methods A female patient of forty four years old with frequent attacks of paroxysmal AF for 4 years was subjected to catheter ablation.A decapolar catheter was put into the left atrium and PV through transseptal approach.Spontaneous AF appeared after isoproterenal infusion.The trigger point of AF was found to be the from the left supperior pulmonary vein(LSPV). Results After 3 applications of radiofrequency energy in LSPV,the trigger and AF was eliminated.During a follow up period of about 6 months,the patient only had 3 episodes of AF within the first 2 weeks of the post ablation days and had no recurrence there after without any antiarrythmic drugs. Conclusion The therapy by radiofrequency catheter ablation is a safe and effective method for focal AF originating from PVs.