经冠状静脉窦射频导管消融房室旁路的疗效和安全性  

Efficacy and Safety of Radiofrequency Catheter Ablation of Accessory Pathways Through the Coronary Sinus

作　　者：楚建民[1] 马坚[1] 王方正[1] 张奎俊[1] 孙瑞龙[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院临床电生理研究室,北京市100037

出　　处：《中国循环杂志》2000年第5期289-290,共2页Chinese Circulation Journal

摘　　要：目的 :探讨经冠状静脉窦低能量射频导管消融房室旁路的适应证、疗效和安全性。　　方法 :2 2例左侧房室旁路患者先经心内膜射频导管消融 ,不成功改由经冠状静脉窦标测途径。　　结果 :2 2例患者全部成功 ,17例 (77.3% )成功靶点与冠状静脉分支或畸形有关。 15例有效靶点记录到振幅较大的房室旁路电位 ,其振幅于 A波和 V波之比大于 1,前传 V波和逆传 A波较心内膜标测分别提前 2 6 .1± 5 .1m s和 2 2 .5±9.2 m s。　　结论 :低能量冠状静脉窦射频导管消融可以安全、有效的阻断房室旁路。Objective:To assess the indication of success,efficacy,and safety of catheter ablation of left accessory pathways by radiofrequency energy through the coronary sinus. Methods:The study group comprised 22 patients with posteroseptal or posterlateral and 2 patients with left free wall accessory pathways.Endocardial mapping was used first,if this endocardial approach was unsuccessful,the ablation catheter was introduced into the coronary sinus and energy applied. Results:All 22 patients had successful ablation within the coronary sinus.Sewenty seven point three per cent.successful sites were related to coronary sinus abnormalities or venous branches.In 15 patients the effective target site electrograms in coronary sinus were characterized by accessory pathway potential that was larger than the corresponding atrial and ventricular electrogram. Conclusions:The absence of an accessory pathway potential during endocardial mapping,a relatively large accessory pathway potential within the coronary sinus in combination with coronary sinus abnormalities and venous branches may be a useful marker of catheter ablation through coronary sinus.Low energy radiofrequency catheter ablation through coronary sinus appears to be safety and enhance efficacy.

关 键 词：冠状静脉窦 房室旁路 射频导管消融术 疗效 

分 类 号：R541.705[医药卫生—心血管疾病] R454.2[医药卫生—内科学]