高频电能选择性消蚀房室传导系的实验研究

Transcatheter Selected Ablation of the Atrioventricular Conduction System in Dogs Using High-frequency Energy

作者采用2590kHz的高频电能(HFE)仪,经导管选择性消蚀了18只犬房室传导系的不同区域,15只(急性实验8只,慢性实验7只)犬形成了不同的传导阻滞,其中选择消蚀了7只犬的房室结区、6只犬的束支区、2只犬的分支区。有9只犬形成Ⅲ度房室传导阻滞(AVB)、1只犬形成Ⅱ度AVB、3只犬形成Ⅰ度AVB、2只犬形成完全性右束支传导阻滞(1只伴1度AVB)。另3只犬各释放电能13次均未成功。主要并发症为附壁血栓形成。本结果表明HFE是一种较为理想的能量形式,易控制,消蚀损伤组织范围局限,效果满意,不失为治疗顽固性快速心律失常有发展前途的一种方法。

Transcatheter selected ablation of the various areas of the atrioventricular conduction system in 18 dogs was performed using high frequency energy (HFE), which was generated from a modified electrosurgical generator(frequency 2590kHz). Ablation was successful in 15 dogs and not in the rest of 3 dogs. The area of selected ablation of 7 dogs was in AV node, 6 in his bundle, 2 in his bundle branch. Three degree AV block was induced in 9 dogs, two degree in 1, one degree in 3, and Complete right bundle branch block in 2, one of them complicated by one degree AV block. The main complication of ablation using HFE was thromboembolism. The results showed that the HFE was a ideal energy source for ablation and it might be controlled and induce circumscribed areas of necrosis. It might be a promising method for treatment of refractory tachyarrhythmias.