右房房性心动过速电生理学特征及射频消融结果  

Electrophysiologic characteristics and the results of radiofrequency ablation for atrial tachycardia in right atrium

作　　者：吴书林[1] 李海杰[1] 杨平珍[1] 詹贤章[1] 郑祥生[1] 方咸宏[1] 欧阳非凡[1] 

机构地区：[1]广东省心血管病研究所,广州市510100

出　　处：《岭南心血管病杂志》1999年第3期159-161,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的 探讨右房房性心动过速(房速)的电生理学特征、靶点标测和射频消融治疗结果。方法 40例右房房速病人行心内电生理检查和射频消融,房速靶点标测采用激动标测方法,用两根大头消融导管在右房内交替移动标测寻找靶点,采用预设60～65℃温控放电消融。结果 经电生理检查证实40例房速中10例为自律性房速,30例为非自律房速。36例(90％)射频消融即刻成功,36例有39个房速病灶位,其分布:房间隔21个,右房侧壁15个,希氏束旁(Koch三角尖)2个。4例合并房室结折返性心动过速改良房室结成功,3例合并心房扑动划线消融成功。有1例希氏束旁房速术后出现Ⅲ°AVB。结论 右房房速射频消融成功率较高,其病灶部位以房间隔或右房侧壁为多见,希氏束旁房速消融应注意防止出现AVB并发症。ve To investigate electrophys-iologic characteristics and the original site of atrial tachycardia ( AT ) in right atrium and the results of radiofre-quency ablation (RFA). Methods Electrophysiologic study and RFA were performed in 40 patients with AT in right atrium. The site of origin of AT was mapped by using activation mapping during tachycardia and with two large-tipped catheters. During ablation procedure, we used the method of preselecting a temperature of 60 -65°C. Results In 40 patients, electrophysiologic study was showed that the type of AT was automatic mechanism (10 patients) and nonautomatic mechanism (30 patients) . ATs were successfully ablated in 36 patients (90%) . 39 foci in 36 patient with AT were seperately lo-cated in interauricular septum (21 foci), lateral area of right atrium (15 foci) and para-His-bundle area (near the apex of Koch's triangle, 3 foci) . RFA was successful in 4 patients with atrioventricular node reentrant tachycardia combining with AT. Linear ablation was successful in 3 patients with atrial flutter combining with AT. One patient with AT originated from para-His-bundle area was complicated by 3° AVB after RFA. Conclusion It was suggested that the success rate of RFA in AT of right atrium was high. The foci were mainly located in interauricular septum and lateral area of right atrium. We should pay special attention to preventing complication of AVB in the patient with AT originated from para-His-bundle area during ablation procedure.

关 键 词：房性心动过速 电生理学 射频消融 

分 类 号：R541.71[医药卫生—心血管疾病]