穿房间隔射频消融左侧游离壁房室旁道的疗效及安全性评价  

Efficacy and safety of radiofrequency catheter ablation by transseptum for left free wall accessory pathways

作　　者：江洪[1] 黄从新[1] 唐其柱[1] 李庚山[1] 

机构地区：[1]湖北医科大学附属第一医院心内科,430060

出　　处：《岭南心血管病杂志》1997年第2期16-17,59-60,共4页South China Journal of Cardiovascular Diseases

摘　　要：穿房间隔（TS）射频消融左侧游离壁房室旁道（旁道）作为径主动脉左室（TA）消融方法的补充途径已受到重视。本文报道TS治疗52例左侧游离壁旁道的经验，初步评价该法的疗效和安全性。52例病人男29例，女23例。年龄15－68岁。旁道位于左前（24例），左侧（18例）和左后（10例）游离壁。选用Swartz鞘（SL1－SL4）进行房间隔穿刺。穿刺成功后送入鞘管至左房并注入肝素5000u。52例病人均被成功阻断旁道传导。放电次数1－8（27±2．1）次。所有病人术中顺利，无房间隔穿刺相关的并发症。4例病人（左前旁道）放电中感胸痛，2例病人（左后旁道）放电中出现窦性心动过缓。3例病人术后复发，均经TA法再次消融获得成功。结果提示TS途径消融左侧游离壁旁道具有较高的成功率和一定的安全性，可为部分病人，如并存主动脉瓣病变、动脉扭曲、或TA消融失败者的另一补充方法。To evaluate the efficacy and safety of Radiofrequency Catheter Ablation (RFCA) by transseptum for treating left free wall accessory pathways, 52 cases (29 men,age range: 15 to 68 years) were treated by this method. Among free wall accessory pathways, 24 was left anterior, 18 left lateral, 10 left posterior. All patients were ablated successfully, the times of discharge ranged from 1 to 8 (2. 7 +2. 1 ), No complications related to transseptum were found.During delivery, four patients with left anterior accessory pathways felt chest pain, bradycardia was found in 2 cases with left anterior pathways. 3 recurrent cases were ablated successfully by repeated ablation. The results indicate that RFCA of lft free wall atrioventricular accessory pathways by transseptum has a relatively high success the all safety, and it could act as a complementary approach to RFCA by transaorta.

关 键 词：房间隔穿刺 房室旁道 射频消融 

分 类 号：R54[医药卫生—心血管疾病]