右侧房室旁道射频消融治疗室上性心动过速  

Experience on Radiofrequency Catheter Ablation of Right Atrioventricular Accessory Pathway

作　　者：孟伟栋[1] 汪芳[1] 陈岗[1] 张峰[1] 孙宝贵[1] 

机构地区：[1]上海交通大学附属第一人民医院心内科,上海200080

出　　处：《中国临床医学》2008年第3期299-300,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:总结右侧房室旁道经导管射频消融治疗的操作技巧。方法:采用导管射频消融阻断右侧房室旁道治疗房室折返性心动过速70例(男性29例,女性41例),其中双旁道5例。结果:70例患者中经射频消融治疗首次成功68例(97.14%),随访11个月～5年,复发6例(8.82%),5例再次成功消融,其中1例共消融3次。消融手术时间154.57±73.22min,X线曝光时间15.17±11.33min。有2例患者出现完全性房室传导阻滞。结论:射频消融治疗右侧房室旁道成功率较高,准确的靶点定位及导管和靶组织的稳定接触是减少复发的关键,希氏束旁旁道的消融易并发房室传导阻滞,需更加注意靶点的准确性以及采取适宜的消融能量和时间。Objective：The patients of right atrioventricular accessory pathway treated with radiofrequency catheter ablation（RFCA） were analyzed for a pratical and effective ablation experience.Methods：Seventy patients cases with right atrioventricular accessory pathway were treated by RFCA,including 29 males and 41 females.Among them,5 patients were with dual accessory pathway.Results：97.14% of patients successfully treated with RFCA for the first time.During the follow-up of 11months to 5 years,6 cases had recurrence of conduction problems（recurrence rate 8.82%）.Five of the 6 patients were successfully treated again,one of them was treated for 3 times.RFCA procedural time 154.57±73.22 minutes,X rays exposure time 15.17±11.33 minutes.Two cases had a complication of complete atrioventricular block.Conclusion：The right atrioventricular accessory pathway treated with RFCA has high success rate,the precise mapping and catahter stability are the key of decreasing recurrence rate.The treatment with RFCA for the pathways that is close to bundle may cause the complication easily.We must emphasize the precise mapping and take the suitable ablation energy and time.

关 键 词：右侧房室旁道 导管射频消融术 完全性房室传到阻滞 

分 类 号：R541[医药卫生—心血管疾病]