成功消融右房峡部依赖型心房扑动的径线位置及临床特点

The position and clinical charaters of successful ablation lines in right atrial isthmus in atrial flutter patients

目的总结成功治疗右房峡部依赖型心房扑动（简称房扑）的消融线位置及临床特点。方法收集2009年至2014年间成功消融的右房峡部依赖型房扑患者的临床资料，分析总结成功消融的消融线位置及特点。结果共274例患者入选，年龄[54．1±13．8（14—84）]岁，65例（23．7％）为心脏外科术后患者。术中266例（97．1％）在6点钟位置消融成功，8例（2．9％）在7-8点钟位置消融成功。后者心脏外科术后的比例及再次／多次消融的患者比例明显高于前者。结论对于绝大部分右房峡部依赖型房扑患者，于6点钟位置消融即可，极少数患者需于偏游离壁位置（7-8点钟）方可消融成功，特别是对于心脏外科术后患者及曾消融失败的患者。

Objective To observe the position and clinical characters of successful ablation lines in cavotricuspid isthmus dependent atrial flutter. Methods From 2009 to 2014, the patients with typical atrial flutter accepted abhion were enrolled in the study, the clinical characteristics and follow-up were collected. Result Two hundred and seventy-four patients were enrolled, including 65 postoperative patients （23.7%）. The mean age at the time of RFCA was （54.1± 13. 8） years （range, 14-84 years）. Successful ablation lines were obtained at the 6 o＇clock position in 266 patients （97.1%） ; the 7-8 o＇clock position in 8 patients （2.9%）. Compare to 6 o＇clock position group, the proportion of patients with postopertive and repeated ablation was significantly higher in the 7-8 o＇clock position group. Conclusion In most typical atral flutter, successful ablation lines are obtained at the 6 o＇clock position, only rare patient need ablation in the 7-8 o＇clock position, especially in postopertive and repeated ablation patients. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2015,29 （6） ：519-5211]