经静脉穿房间隔和经动脉逆行消融左侧旁道的比较  

Radiofrequency catheter ablation by transaortic approach compared with that by transseptal approach for left-sided accessory.

作　　者：唐安丽[1] 王业松[1] 何建桂[1] 冯冲[1] 柳俊[1] 吴素华[1] 廖新学[1] 刘君[1] 董吁钢[1] 

机构地区：[1]广州中山大学附属第一医院心内科,广东广州510080

出　　处：《中国心脏起搏与心电生理杂志》2009年第5期396-398,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的探讨经静脉穿房间隔和经动脉逆行途径行左侧旁道消融的有效性和安全性。方法133例左侧旁道患者,71例经主动脉逆行标测消融(经主动脉逆行组),62例经静脉穿房间隔心房侧旁道消融(经静脉穿房间隔组)。比较两组放电时间及次数、X线曝光时间、手术总时间,手术效果及安全性。结果经静脉穿房间隔组的放电时间及次数、X线曝光时间、手术总时间较经动脉逆行组均明显缩短(P<0.01),即刻成功率100%;经主动脉逆行组有3例左前外侧旁道者需改经静脉穿房间隔消融成功,即刻成功率96%(68/71)。两组均无并发症。随访15.3±11.3个月,共有3例复发经再次消融成功;其中经动脉逆行组有2例复发,复发率为2.8%;而经静脉穿房间隔组有1例复发,复发率为1.6%。结论经静脉穿房间隔心房侧左侧旁道消融可行、安全、有效,消融导管易于到位,消融时间及放电时间减少。Objective To evaluate the efficacy and safety of radiofrequency catheter ablation by transaortic and trans- septal for left-sided accessory pathways. Methods One hundred and thirty-three patients with left-sided accessory path- way-mediated tachyarrhythmias were enrolled. Seventy-one cases were treated by transaortic approach （transaortic group） , while 62 cases by transseptal approach （transseptal group）. To compare the radiofrequency lesions, radiation exposure, procedural duration, efficacy and security of the groups. Results The transseptal approach resulted in decreased procedural duration, radiation exposure, and radiofrequency lesions compared with the transaortic technique （P 〈 0.01 ）. The success rate of primary ablation was 100% （62/62）. Whereas in transaortic group 3 cases cannot but switch to transseptal because of failure. The success rate of primary ablation was 96% （68/71）. During a mean follow-up of 15.3 ± 11.3 months, 3 recurrent cases were ablated successfully by repeated ablation. Two cases recurred in transaortic group in which recurrent rate was 2.8% ,while one case in transseptal group in which recurrent rate was 1.6%. Conclusion It is efficacy and safety of radiofrequency catheter ablation by transseptum for left-sided accessory pathways. Besides that, it is easy for ablation catheter to be in position, and the time of ablation and discharge can be also reduced. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2009,23 （5） ：396 -398 ]

关 键 词：电生理学 消融途径 左侧旁道 导管消融 射频电流 

分 类 号：R541.71[医药卫生—心血管疾病] R542.2[医药卫生—内科学]