逆行慢传导房室旁路的射频导管消融术  

Radiofrequency catheter ablation of accessory pathway with slow and decrement conduction

作　　者：杨新春[1] 商丽华[1] 胡大一[1] 贾三庆[1] 李田昌[1] 张建军[1] 

机构地区：[1]首都医科大学附属北京红十字朝阳医院心脏中心

出　　处：《中华心血管病杂志》1997年第3期201-203,共3页Chinese Journal of Cardiology

摘　　要：报道１１例在射频消融成功部位靶点不能标测到ＶＡ波融合的逆行慢传导隐匿性房室旁路电生理特点和射频消融。４例心动过速呈连续性，旁路位于间隔部位；７例心动过速呈阵发性，旁路均位于左侧游离壁。消融成功部位靶点图ＶＡ波不融合，ＶＡ间期１１５±１６ｍｓ，ＶＡ波之间等电位线间期１０～５０ｍｓ。Long VA time and separation of local ventricular and atrial deflection can be recorded at target site of successful ablation accessory pathway in a few patients with slow and decrement conduction. This report describes radiofrequency catheter ablation of accessory pathways in 11 patients with slow and decrement conduction and characteristics of this kind of accessory pathways. Orthodromic reciprocating tachycardia was recorded in all patients with the cycle length ranging from 300 to 390 ms (mean 352±26 ms).Four patients with nearly incessant tachycardia. In one patient accessory pathway was located in the right posteroseptal region. Three were in the right anterioseptal region. Seven patients with paroxysmal tachycardia. Retrogarde conduction over accessory pathway exhibited decremental conduction, the maximal decrement ranged from 20 to 40 ms. Retrograde effective refractory period averaged 244±37 (ranged from 200 to 300) ms. Accessory pathways were attempted at site from which the earliest retrograde atrial activation was recorded during tachycardia or pacing right ventricle. The VA interval averaged 115±16 ms in target electrogram. Isoelectric interval between V wave and A wave in target site ranged from 10 to 50 ms. All of the 11 patients had successful ablation.

关 键 词：预激综合征 导管消融术 

分 类 号：R541.770.5[医药卫生—心血管疾病]