导管法射频消融房室旁道的临床应用(附37例报告)

CLINICAL APPLICATION OF RADIOFREQUENCY CURRENT CATHETER ABLATION IN ATRIOVENTRICULAR ACCESSORY PATHWAY

报告射频消融治疗房室旁道折返性室上性心动过速37例的体会。其中左侧旁道31例,右侧旁道6例,使用端电极为4mm的可操纵电极导管,分别在左室二尖瓣环下房室环处和三尖瓣环心房侧标测最短的A-V间期和最短的V-A间期为定位指标。射频电流释放于端电极与体表板状电极之间。6例左侧旁道中成功28例,6例右侧旁道均未阻断。成功的28例平均消融次数10±6次;平均手术时间3.32±1.19h;平均射频输出能量4835±2176J,随访1～13个月无复发。

This paper reports the result of radiofrequency current catheter ablation in treating 37 patients with supraventricular tachyarrthymias mediated by the accessory pathway (AP). 31 of them had left-sided AP, 6 of them had right-sided AP. For the left sided, it was to be detected in the left ventricle beneath the mitral valvular leaflet, close to the mitral annulus and the right-sided AP in the right atrium near the tricuspid annulus, using a steerable 7F quadripolar catheter with a tip electrode, 4mm across. The criterion of AP locating was the shortest A-V interval or V-A' interval. RFC was applied between the 4 min tip electrode and paddle electrode on the body surface of patient. The 28 AP patients on the left were found successfully ablated, while in 6 patients with right-sided AP and in 3 patient with left-sided AP it was unsuccessful. Of the 28 successful cases, the median number of ablation application was 10±6 times, the median time of operation 3.32±1.19 hours and the median total energy 4835±2179 J. The 28 successful cases had no recurrence at following-up 1-13 months afterwards.