射频导管消融术治疗房性心动过速的疗效观察

Observation of treatment on atrial tachycardia with radiofrequency catheter ablation

目的 探讨房性心动过速 (AT)的电生理特点及射频导管消融术 (RFCA)的治疗效果。 方法程序和分级递增刺激诱发AT ,并用单个或双大头消融电极导管于AT时标测心房最早激动点 (EAA)放电消融。结果 12例符合折返性AT的电生理特点 ,3例系自律性增高所致。起源部位在冠状静脉窦口附近 10例 ,右心房侧壁 3例 ,右心耳部 1例 ,左心房右上肺静脉口 1例。 15例AT经RFCA治疗全部成功 ,无并发症。随访 2～ 42个月 ,仅 1例位于右心耳部AT并于术后 1个月复发。结论 AT最常见的起源部位是冠状静脉窦口附近 ,其次是右心房侧壁 ,RFCA治疗AT安全、有效 。

Objective To study the electrophysiological characteristics of the 15 atrial tachycardia(AT) and the results of radiofrequency catheter ablation(RFCA).Methods Inducing AT with programmable and graded increscent stimulant,mapping the earliest atrial activation (EAA)with one or two big-tip ablation electrodes during AT.Results 12 ATs were related with reentrant mechanism,3 ATs were induced by automaticity,and 10 ATs originated near coronary sinus ostium(CSo),3 ATs at right atrium lateral(RAL),1AT at right atrium appendage,1 AT in the right upper pulmonary vein ostium,15 ATs were successfully cured with RFCA,no complications.Following up for 2～42 months,only 1 AT at right atrium appendage recurred,successfully ablated again.Conclusion The most common site for AT is near coronary sinus ostium,the right atrium lateral is the secondly common site,and RFCA is a safe and effective way to cure AT.