经左侧间隔部消融治疗常规方法失败的房室结折返性心动过速  

Left-septal ablation therapy as an adjunctive approach for atrioventricular nodal reentrant tachycardia resistant to conventional right side slow pathway modification

作　　者：周小雄[1] 刘方舟[2] 詹贤章[2] 薛玉梅[2] 廖洪涛[2] 方咸宏[2] 

机构地区：[1]广州中医药大学第一附属医院心血管科,广东广州510080 [2]广东省人民医院心血管内科广东省心血管病研究所

出　　处：《中国心脏起搏与心电生理杂志》2017年第1期29-32,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金资助(编号81370295)

摘　　要：目的分析经左侧间隔部消融成功的房室结折返性心动过速(AVNRT)。方法广东省人民医院心血管病研究所心血管内科2012年1月至2015年11月收治的经左侧间隔部消融成功的AVNRT8例,回顾性分析其导管射频消融的方法及特点。结果 8例患者中男性3例,女性5例,年龄(53.5±18.9)岁,术前均有反复发作的阵发性室上性心动过速病史,8例患者经右侧间隔部反复消融仍无法达到消融终点,其中5例经右侧间隔部消融后术后仍可诱发心动过速,3例有稳定的跳跃及连续回波现象,后分别经主动脉逆行或经房间隔穿刺行左侧间隔部消融取得成功,左侧消融放电次数(5.8±1.9)次,放电时间(47.9±16.2)s。结论右侧间隔部消融无效的AVNRT,可能属左侧后延伸支参与的AVNRT,可通过左侧间隔部慢径区域消融治疗。Objective To investigate the effect of atrioventricular nodal reentry tachycardia（AVNRT） with left- septal ablation. Methods Catheter ablation approach and results were analyzed retrospectively of AVNRT of 8 pa- tients with left-septal ablation from January 2012 to November 2015 in the Department of Cardiology, Guangdong Cardiovascular Institute,Guangdong Provincial People＇s Hospital. Results There were 3 males and 5 females, age was （53.5 ± 18.9 ）years old, and had a history of recurrent episodes of paroxysmal sup raventricular tachycardia before ablation, 8 patients with the right septal ablation is still unable to reach the end of ablation, After ablation of the right septal, 5 patients could still induce tachycardia, 3 cases with stable jumps and continuous echo phenome- na, After retrograde or through the atrial septal puncture, the left- septal ablation was successful,the average num- ber of discharges in the left- septal ablation was（5.8±1.9） ,time was （47.9±16.2）s. Conclusions If the right-sep- tal ablation is not effective, may be involved in the left posterior extension of the AVNRT. Catheter ablation thrapy of slow pathway in the left-septal can be performed.

关 键 词：心血管病学 房室结折返性心动过速 导管消融 射频电流 右侧后延伸支 左侧后延伸支 

分 类 号：R541.71[医药卫生—心血管疾病] R454.1[医药卫生—内科学]