9例矫正型大动脉转位合并室上性心动过速射频消融回顾性分析  

Retrospective analysis of radiofrequency catheter ablation of supraventricular tachycardia in 9 patients with congenitally corrected transposition of the great arteries

作　　者：翁思贤 唐闽 方丕华[1] 贾玉和 马亚哲 郭金锐 郭雨龙 刘可 张澍[1] WENG Si-xian;TANG Min;FANG Pi-hua;JIA Yu-he;MA Ya-zhe;GUO Jin-rui;GU() Yu-long;LIU Ke;ZHANG Shu(Center for Arrhythmia,Fuwai Hospital,Chinese Academy Medical Science,National Center for cardiovascular Disease , Peking Union Medical College, Beijing 10037, China;Funwai Yunnan Cardiovascular Hospital,Kunming, Yunnan,China)

机构地区：[1]国家心血管病中心北京协和医学院中国医学科学院阜外医院心律失常中心,北京100037 [2]云南省阜外心血管病医院

出　　处：《中国心脏起搏与心电生理杂志》2019年第2期107-111,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：射频消融导管临床研究(横向课题)(项目编号:T2016-QX001)

摘　　要：目的回顾性分析矫正型大动脉转位(ccTGA)合并室上性心动过速(SVT)射频消融特点及结果。方法连续入选9例ccTGA合并SVT患者,完善术前检查后行心内电生理检查及射频消融术,术后定期随访、收集资料。结果 9例患者中,4例房室结折返性心动过速、3例房室折返性心动过速、2例房性心动过速,均于靠近间隔侧消融成功。三维使用率达55.5%(5/9),其中2例心脏解剖变异较大(1例中位心、1例右旋心),应用三维电解剖模型融合CT建模辅助消融均获得成功。术后1例HV间期从40 ms延长至100 ms,其余无明显改变。随访3～75个月1例复发。结论此类患者的术中定位应更加关注左右房间隔侧的标测;ccTGA合并SVT的患者可首选三维电解剖模型融合CT建模辅助射频消融治疗。Objective To retrospective analysis of radiofrequency catheter ablation(RFCA)of supraventricular tachycardia(SVT)in 9 patients with congenitally corrected transposition of the great arteries(ccTGA). Methods Nine patients with ccTGA referred for RFCA of SVT were studied. Results All 9 patients,contained 4 atrioventricular nodal reentrant tachycardias,3 atrioventricular reentrant tachycardias and 2 atrial tachycardias,were ablated successfully in septum of atrium. 55.5%(5/9)patients were used 3-D mapping. Two of 9 ablated successfully who suffered great anatomic variation of heart were used electroanatomical map merged with 3 D anatomical structure reconstructed from CT slices. After RFCA, patients had no change with the HV interval except one extended from 40 ms to 100 ms. One patient relapsed after Follow-up 3 to 75 months. Conclusions This type of patients should more concern about the mapping in septum of atrium;During RFCA,electroanatomical map merged with 3 D anatomical structure reconstructed from CT slices could be the first choice for SVT patients with ccTGA.[Chinese Journal of Cardiac Pacing and Electrophysiology,2019,33(2):107-111]

关 键 词：心血管病学 矫正型大动脉转位 室上性心动过速 导管消融 射频电流 

分 类 号：R541.72[医药卫生—心血管疾病] R454.1[医药卫生—内科学]