9例矫正型大动脉转位合并室上性心动过速射频消融回顾性分析

Retrospective analysis of radiofrequency catheter ablation of supraventricular tachycardia in 9 patients with congenitally corrected transposition of the great arteries

目的回顾性分析矫正型大动脉转位(ccTGA)合并室上性心动过速(SVT)射频消融特点及结果。方法连续入选9例ccTGA合并SVT患者,完善术前检查后行心内电生理检查及射频消融术,术后定期随访、收集资料。结果 9例患者中,4例房室结折返性心动过速、3例房室折返性心动过速、2例房性心动过速,均于靠近间隔侧消融成功。三维使用率达55.5%(5/9),其中2例心脏解剖变异较大(1例中位心、1例右旋心),应用三维电解剖模型融合CT建模辅助消融均获得成功。术后1例HV间期从40 ms延长至100 ms,其余无明显改变。随访3～75个月1例复发。结论此类患者的术中定位应更加关注左右房间隔侧的标测;ccTGA合并SVT的患者可首选三维电解剖模型融合CT建模辅助射频消融治疗。

Objective To retrospective analysis of radiofrequency catheter ablation(RFCA)of supraventricular tachycardia(SVT)in 9 patients with congenitally corrected transposition of the great arteries(ccTGA). Methods Nine patients with ccTGA referred for RFCA of SVT were studied. Results All 9 patients,contained 4 atrioventricular nodal reentrant tachycardias,3 atrioventricular reentrant tachycardias and 2 atrial tachycardias,were ablated successfully in septum of atrium. 55.5%(5/9)patients were used 3-D mapping. Two of 9 ablated successfully who suffered great anatomic variation of heart were used electroanatomical map merged with 3 D anatomical structure reconstructed from CT slices. After RFCA, patients had no change with the HV interval except one extended from 40 ms to 100 ms. One patient relapsed after Follow-up 3 to 75 months. Conclusions This type of patients should more concern about the mapping in septum of atrium;During RFCA,electroanatomical map merged with 3 D anatomical structure reconstructed from CT slices could be the first choice for SVT patients with ccTGA.[Chinese Journal of Cardiac Pacing and Electrophysiology,2019,33(2):107-111]