经食管超声心动图在旁路射频消融术中价值的探讨

Transesophageal Echocardiography during Radiofrequency Atheter Ablation of Atrioventricular Accessory Pathways

目的 :研究食道超声心动图 (TEE)在左侧和右侧房室旁路射频消融术中 (RFCA)监测的意义。方法 :对 31例房室旁路患者进行 RFCA术的 TEE检查。结果 :RFCA术全部成功。TEE食道留置时间为 35± 1 1 min。 TEE导引了全部患者的消融电极的放置和位置调整 ,诊断器质性病变3例 ,导引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返流 ,及时调整消融电极位置后消失。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 。

Objective: To evaluate the role of transesophageal echocardiography (TEE) in monitoring patients during radiofrequency catheter ablation (RFCA). Methods: Thirty one RFCA procedures were performed in 25 patients with left side accessory pathway and 4 patients with right side accessory pathway. Under local lidocain gel anesthesia, all patients were monitored during RFCA with TEE. Results: TEE was used to detect underlying heart diseases in 3 patients, guide transseptal catheterization in 3, and find transient moderate mitral regrugitation in 2 during RFCA. It helped position the RFCA catheter's tip, and evaluate for possible complications in all patients.Conclusion: This study suggestes that TEE might be useful in RFCA procedures under local anesthesia.