宽旁道射频消融及其临床价值

Radiofrequency ablation of wide accessory pathway

将 6例具有宽旁道电生理特点的心动过速患者 (均为左侧旁路 )在右前斜位 30°于二尖瓣环心室侧细标靶点 ,每一理想靶点 2 5 W试消融 1min,直至完全阻断旁路。结果 :6例患者成功消融旁路 ,消融范围 1.6～2 .9cm,平均为 (2 .2± 0 .8) cm,消融靶点数 5～ 9次 ,平均为 (5 .6± 2 .3)次 ,消融时间为 1.1～ 3.1小时 ,平均为(1.3± 1.2 )小时。认为增强对宽旁道电生理特征的认识 ,耐心细致标测靶点 ,在较大范围消融 ,可提高宽旁道消融的成功率。

In order to explore the method and feasibility or radiofrequency ablation of wide accessory pathway,six patients(male 4,female 2,mean age 35 2±6 5 years old)with left wide accessory pathway diagnosed by electrophysiologic study were ablated through right anterior oblique objection 30° The ideal target sites were carefully mapped along mitral annulum in left ventriculum Radiofrequency energy of 25 watts was delivered for l minute at every ideal target site until the pathway was blocked successfully The results showed the wide accessory pathway in 6 patients were ablated completely with mean ablation range 2 2±0 8 cm(1 6～2 9cm),mean ablation target sites 5 6±2 3(5～9)and mean ablation time 1 3±1 2 hours(1 1～3 1 hours) This suggests full understanding the eletrophysiologic characteristics of wide accessory pathway,careful mapping and ablating in a relatively large range may help increase the success rate of this type of ablation