局灶性心房颤动的射频导管消融治疗

Catheter radiofrequency ablation of local atrial fibrillation

目的 报道 2例局灶性房颤的射频消融结果。方法 常规穿刺置入冠状窦电极、希氏束电极 ,右室心尖电极和 /或右房Halo电极 ,确定诱发房颤的房早起源的大致部位 ,对起源于左房者 ,穿刺房间隔 ,置入标测电极至左、右上肺静脉和左下肺静脉 ,确定起源后进行电隔离消融。结果 例 1为阵发性房颤 ,起源于左上肺静脉 ,例 2为“无休止性”房颤 ,起源于右房后侧游离壁。例 1采用 8mm大头消融电极 ,对左上肺静脉主干进行片状消融 ,功率 2 0W ,放电 7次 ,消融成功。例 2先采用最早激动部位消融未成 ,后改为“井”形线性消融 ,获得即刻成功。随访 16和 15个月 ,例 1房颤未发作 ,例 2术后 15d房颤复发。术中、术后无并发症。

Objective It was report that ablative results of two patients with local atrial fibrillation. Methods Electrical isolation of left upper pulmonary vein was made by radiofrequency current with 8 mm large tip catheter in case 1, Double cross linear ablation was made in case 2. Results After the procedure of catheter ablation, atrial fibrillation was eliminated in case 1. During following 16 months, atrial fibrillation had no recurrence. Case 2 was incessant atrial fibrillation originating from right posterior free wall of right atrium and atrial fibrillation was eliminated by linear ablation, but after 15 days, atrial fibrillation recovered. There were no complications during and after the procedure. Conclusion Catheter radiofrequency ablation of local atrial fibrillation is a safe and effective treatment.