经食管超声心动描记术在旁路射频消融术中的价值

The value of transesophageal echocardiography during radiofrequency catheter ablation of atrioventricular accessory pathways

目的 探讨经食管超声心动图 (TEE)在阵发性室上性心动过速患者左侧和右侧房室旁路射频消融 (RFCA)术中监测的意义。方法 应用TEE技术对 3 1例单发旁路 (左侧旁路 2 7例 ,右侧旁路 4例 )的室上性心动过速患者行RFCA术中监测。结果 RFCA术均获成功。TEE引导了全部患者消融电极的放置和位置调整 ;引导穿房间隔术和穿隔后的电极放置 3例 ;发现 2例消融过程中出现中度二尖瓣反流 ,及时调整消融电极位置后反流消失。结论 在RFCA术中行TEE监测有助于电极的定位和防止电极脱位 ,及时发现并发症 ,引导冠状窦电极放置和穿房间隔消融。

Objective To evaluate the role of transesophageal echocardiography (TEE) in monitoring patients under local anesthesia during radiofrequency catheter ablation (RFCA).Methods Thirty one RFCA procedures were performed in 31 patients with supraventricular tachycardia,including 27 patients with single left side accessory pathway and 4 patients with single right side accessory pathway. Under local lidocain gel anesthesia, all patients were monitored with TEE during RFCA. Results TEE was used to help positioning the RFCA catheter's tip and evaluated possible complications in all patients, guided transseptal catheterization in 3 patients, and found transient moderate mitral regurgitation in 2 patients during RFCA.Conclusions TEE is useful in RFCA procedures under local anesthesia for guiding transseptal procedure, helping the proper position of ablation and coronary sinus catheters, and detecting complications in early stage.