后位峡部线性消融法治疗典型心房扑动

POSTERIOR ISTHMUS LINER RADIOFREQUENCY CATHETER ABLATION OF TYPICAL ATRIAL FLUTTER

目的 :采用右心房后位峡部线性消融治疗典型心房扑动。方法 :典型心房扑动 (AFL) 2 3例 ,对三尖瓣环至下腔静脉口之间的后位峡部为靶点行线性消融术 ,以峡部双向阻滞和异丙肾上腺素或阿托品激发后程序刺激和burst刺激不能诱发临床AFL为消融终点。结果 :本组患者均为逆钟向典型房扑 ,消融后均达到峡部完全性双向阻滞 ,即刻消融成功率为 10 0 % ,未出现并发症。随访 6～ 3 4周有 1例复发 ,再次行射频消融术成功。结论 :采用后位峡部线形消融典型心房扑动是一种高成功率和安全性 ,低并发症和复发率的根治性手术。完全性峡部双向阻滞是手术成功的良好指标和消融终点 。

Objective:Typical atrial flutter(AFL) was treated by posterior isthmus liner radiofrequency catheter ablation(RFCA) technique.Methods:23 patients diagnosed as having typical AFL were included in this study.The posterior isthmus between inferior vena cava and tricuspid valve annulus was the ablation target.Results:RFCA end point was posterior isthmus double direction block and no clinical flutter could be induced by programmed or burst stimulates with isoproterenol.All patients have got the end point and instant success rate was 100%.Only one case suffered recurrence in 6～34 weeks' follow-up and was successfully ablated in the second procedure.No complication was observed.Conclusions:Posterior isthmus liner RFCA was an effective and safe way in treating typical AFL.Isthmus double direction block and no flutter could be induced by programmed or burst stimulates with isoproterenol were trustworthy procedure end point.