预激综合征并心房纤颤的射频治疗

Radiofrequency ablation treatment of atrial fibrillation complicating pre-excitation syndrome.

本文报告 11例预激综合征并心房纤颤 (Af)的射频消融治疗结果。 11例均无器质性心脏病。经心内电生理检查及标测 ,左侧显性旁道 9例 ,右侧显性旁道 1例 ,右侧隐匿性旁道 1例。 10例窦律下消融 ,1例Af时消融 ,经射频治疗均获成功。术后随访 3～ 14个月 ,无Af及室上性心动过速发作。支持显性旁道患者心室收缩提前导致心房内压力升高及心房肌电不稳定是预激综合征患者Af发生机理的论点。同时提示Af时射频消融左侧显性旁道是可行的。其消融成功的靶点图特点为 :1 不规则小A大V波 ;2 V波较体表心电图宽大QRS波的提前程度。

The clinical manifestations,diagnosis,and therapeutic results of 11 patients were analysed.All had normal heart structures.Among them,9 patients had left manifest accessory pathways,1 patient had right concealed accessory pathway,and 1 patient had right manifest accessory pathway.10 patients during sinus rhythm and 1 patient during atrial fibrillation were successfully treated with RFCA.The results showed that it was feasible to ablate left-sided and right-sided accessory pathways during sinus rhythm or atrial fibrillation.