经桡动脉途径射频消融A型预激综合征的方法学研究  

New approach for radial artery puncture in the radiofrequency ablation of type a preexcitation syndrome

作　　者：江洪[1] 张美春[1] 杨波[1] 黄鹤[1] 吴钢[1] 万军[1] 赵冬冬[1] 吴校林[1] 刘华芬[1] 王晓红[1] 黄从新[1] 

机构地区：[1]武汉大学人民医院心内科,430060

出　　处：《中华心律失常学杂志》2008年第3期224-226,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的探讨桡动脉途径建立方法，评价该途径用于左侧房室旁路消融的疗效和安全性。方法选择20例A副预激综合征（左侧房室旁路）为研究对象；采用桡动脉穿刺置入6F长鞘作为5F消融导管进行左心空二尖瓣环标测和消融途径；经锁骨下或颈内静脉穿刺置入两个6F动脉鞘并插入冠状静脉窦和右心事电极导管，用于心房和心室局部记录和刺激的途径。结果20例病人顺利经桡动脉插入鞘管和消融导管，二尖瓣环标测局部电图稳定，危侧旁路均被成功阻断；消融后顺利拔除消融导管和鞘管，无严重并发症。半均随访（3±1．7）个月无复发，穿刺手臂活动正常。结论桡动脉途径配合锁骨下或颈内静脉插管可安全有效地消融左侧旁路。Objective To explore a new ablation approach of radial artery for left-sided accessory pathways （AP） ablation. Methods Twenty consecutive patients with A Wolff-Parkinson-White syndrome （ WPW syndrome） were studied. A 6F long sheathing canal was implanted via radial artery puncture and acted as a route of the ablation catheter. A 5 F ablation catheter was used for mapping and ablation of the APs. Two 6F sheathing canals were placed in the left internal jugular vein or the left subclavian vein by which coronary si- nus （CS） electrode and the right ventricular （RV） electrode were placed. Results Sheathing canals and the catheters were placed and withdrawn in ＇all patients successfully. Local electrograms were recorded steadily from the mitral annulus and all the accessory pathways were ablated successfully. There was not any complication occurred. All patients were followed up for（3 ± 1.7 ） months and no recurrence was noted. Conclusion Assisted by mapping catheters placed through the left internal jugular vein or left subclavian vein, EP test and ablation for the left side AP can be effectively and safely applied via the radial artery puncture.

关 键 词：桡动脉途径 预激综合征 射频消融 

分 类 号：R541.75[医药卫生—心血管疾病]