经冠状窦消融后间隔房室旁路  

Radiofrequency ablation of posteroseptal accessory pathway using coronary sinus approach

作　　者：黄德嘉[1] 姜建[1] 文山[1] 初宁 

机构地区：[1]华西医科大学第一附属医院心内科

出　　处：《中华心血管病杂志》1997年第1期47-49,共3页Chinese Journal of Cardiology

摘　　要：８２例后间隔房室旁路的射频消融术中，５例在常规左后和右后间隔部位消融失败后，经冠状窦消融成功。５例均为预激综合征。体表心电图Ⅱ、Ⅲ、ａＶＦ导联Δ波向下，心室波呈ＱＳ型；Ｖ１导联Δ波４例向上，１例向下，心室波呈Ｒ、ｒＳ或ＱＳ型。除放电中均出现一过性胸痛、１例伴窦性心动过缓外，无其他严重并发症。Because of the anatomic complexity of the posteroseptal region, the ablation of atrioventricular accessory pathway (Aps) situated in this area has posed a challenge to electrophysiologist. In 5 of 82 consecutive patients with manifest Aps located in this region, the ablation in the usual left or right posteroseptal area was not successful. Then a 7 F deflectable ablation catheter was introduced via the right femoral vein and positioned in the coronary sinus. If optimal target electrogram was recorded after precise mapping within the coronary sinus or middle cardiac vein, 15 20 watts of radiofrequency current was delivered. All of the posteroseptal Aps in these 5 patients were blocked successfully by this approach. On electrogram, 5 patients exhibited negative delta and QRS waves on Ⅱ、Ⅲ and aVF, 4 had positive and 1 had negative delta wave on V 1. During radiofrequency delivery, intolerable but transient chest pain occurred in all the patients and remarkable sinus bradycardia in one. Pericardial effussion and other complication were not found.

关 键 词：导管消融术 预激综合征 冠状窦 

分 类 号：R541.770.5[医药卫生—心血管疾病]