射频消融具有Mahaim纤维特性的房室旁路

Radiofrequency catheter ablation of atrioventricular pathways with Mahaim fiber properties

目的 总结报道 3例具Mahaim纤维特性的房室旁路电生理检查及射频消融的结果。方法 3例患者均有阵发性心悸史 ,发作时心电图均表现为宽QRS波 ,其中 1例曾发生晕厥。在进行常规电生理检查后 ,根据旁路电位的描记和 /或心室最早激动点确定消融靶点。结果 3例除具有Ma haim纤维的共同特征外 ,心室最早激动部位均在三尖瓣环附近 ,标测中未能记录到确切的旁路电位 ,根据沿三尖瓣环标测心室最早激动点确定靶点 ,消融均获成功 ,放电次数分别为 8,3 ,6次。结论 在明确此种特殊房室旁路的诊断后 ,可通过沿三尖瓣环标测最早心室激动 ,指导消融并能获得成功 。

Objective The result of electrophysiologic study and ablation of atrioventricular accessory pathways(AP)with the electrophysiologic properties of Mahaim fiber in three patients was summarized and reported.Methods All of the 3 patients(2 male and 1 female)had paraxysmal palpitation.One of them had syncope.After the routine programmed stimulation and ventricular activation sequence mapping(VASM),the ablation target was determined according to the recording of AP potential and/or VASM.Results All patients had the common electrophysiologic properties of Mahaim fiber.The earliest ventricular activation was adjacent to the tricuspid annulus and no definite AP potential was recorded during mapping procedure in all 3 patients.The ablation target were determined according to VASM along the tricuspid annulus and all AP were successfully ablated.The number of radiofrequency applications was 8,3 and 6 respectively.Conclusion After the confirmation of the diagnosis,the successful ablation could be obtained by the guide of VASM along the tricuspid annulus,and the AP potential need not be sedulously seeked.