导管射频消融术治疗右侧房室旁道体会

Clinical experience of right-sided accessory atrioventricular pathway treatment by radiofrequency current catheter ablation

目的 :总结射频消融右侧旁道治疗房室折返性心动过速的效果和经验。方法 :导管射频消融右侧旁道 42例 ,根据心内电生理检查 ,确定右侧房室折返性心动过速 ,采取左前斜位 30°透视下 ,细标消融导管沿三尖瓣环寻找靶点 ,即最短AV和VA间期且A/V比例≤ 1/ 4或AV或VA波融合处即可消融。结果 :除 1例右侧游离壁显性旁道未阻断、逆传阻断外 ,其余 41例旁道均被消融阻断 ,成功率 97 6 %。随访期 2 2± 3 6 ( 1～ 6 4)个月 ,未发现术后并发症。复发 7例 ,4例再次消融成功 ,复发率 2 2 8%。结论 :RFCA治疗右侧房室折返性心动过速安全、有效。

Objective\ To summary the efficacy and experience of radiofrequency catheter ablation (FRCA)for right sided accessory atrioventricular pathway.Methods\ RFCA was made in 42 patients with right-sided accessory atrioventricular pathway.Right sided AVRT were identified by EPS. RFCA was performed under LAO 30° at the shortest A-V and V-A interval or completed fusion of AV ar VA around tricuspid ring.Results\ The successful rate was 97 6%(41/42),the serious complications were not found during the follow up of 22±3.6 months,7 cases had reccurrence after 3 months,with the recurrence rate of 22 8%.Conculsions\ The RFCA could be a safe and effective method for the therepy of right sided accessory atrioventricular pathway.