预激综合征合并完全性房室阻滞的诊断及治疗  

The diagnosis and treatment of Woiff-Parkinson-White syndrome associated with complete atrioventricular block.

作　　者：马坚[1] 王方正[1] 陈新[1] 余培桢[1] 王锦志[1] 张奎俊[1] 李一石[1] 华伟[1] 楚建民[1] 方丕华[1] 孙瑞龙[1] 田瑞国[1] 朱克平[1] 鲁志民[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院,100037

出　　处：《中华心律失常学杂志》1998年第1期33-36,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的报道5例预激综合征合并完全性房室阻滞患者的诊断和治疗。方法进行心内电生理检查和射频消融旁路。结果电生理检查未诱发房室折返性心动过速,心房刺激时体表心电图的预激程度无变化。消融阻断旁路前传后,均示完全性房室阻滞。4例患者在消融术后植入永久性起搏器,随访中无心房颤动发作。1例患者放弃对旁路的消融治疗。结论预激综合征合并完全性房室阻滞是射频消融的适应证。消融前对房室传导功能的评定十分重要。成功消融旁路后应植入永久性起搏器。Objective The clinical and electrophysiologic characteristics of five patients with Wolff- Parkinson-White syndrome and complete atrio-ventricular block and the results of treatmenet were report- ed.Methods Electrophysiologic studies were performed in all five patients and radiofrequency ablation for accessory pathway in four of them.Results During electrophysiologic study,no atrioventricular reentrant tachycardia could be induced,and the morphology of pre-excited QRS complex was not changed by pro- grammed atrial stimulation.Complete atrioventricular block was unmasked when antegrade conduction of accessory pathway was ablated.Except one patient who refused to ablate the accessory pathway,pacemak- ers were implanted in other four patient after ablation ,and no atrial fibrillation occurred during follow-up in these patients.Conclusions Wolff-Parkinson-White syndrome associated with complete atrioventricular block is one of the indications for radiofrequency ablation.It is important to evaluate the function of atri- oventricular conduction system before ablation.Pacemaker should be implanted after successful accessory pathway ablation.

关 键 词：房室阻滞 预激综合征 诊断 治疗 患者 射频消融 永久性起搏器 植入 完全性 旁路 

分 类 号：R541[医药卫生—心血管疾病] R654.2[医药卫生—内科学]