射频消融治疗起源于肺静脉的房性心律失常的临床疗效评价  

Clinical Evaluation of Radiofrequency Ablation in Patients With Atria l Tachyarrhythmias Originating From Pulmonary Veins.

作　　者：江洪[1] 黄从新[1] 唐其柱[1] 杨波[1] 王小红[1] 刘华芬[1] 

机构地区：[1]武汉大学人民医院心内科,武汉430060

出　　处：《中国心脏起搏与心电生理杂志》2003年第1期31-34,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：评价射频消融 1 4例起源于肺静脉的房性早搏 (简称房早 )或房性心动过速 (简称房速 )的临床疗效。 1 4例患者因频发房早 (6例 )和房速 (8例 )而接受肺静脉消融治疗。经房间隔穿刺肺静脉造影确定肺静脉口部及近端 ,大头电极或环状电极标测左房和肺静脉 ,以心律失常的异常电活动最早起源为靶肺静脉和消融靶点 ,消融后房早消失或房速终止且不再诱发和自发为消融终点。结果 :1 4例心律失常起源于右上 (8例 )、左上 (5例 )和左下 (1例 )肺静脉近端 ,1 0例在异常电活动最早部位行局灶点消融达到手术终点 ,4例患者在靶肺静脉口部行多点电隔离消融达手术终点。随访 4～ 2 7个月 ,1例心律失常复发。结论This study evaluated the clinical efficacy of radiofrequency ablation in patients with atrial premature beats (APB) and atrial tachycardia (AT) originat ing from pulmonary veins.Fourteen patients with APB(6 cases) and AT(8 cases) und erwent pulmonary vein ablation.Pulmonary vein angiography was performed after tr ans-septal puncture in order to identify the ostium and proximal segment of pulm onary veins.Activation sequence was mapped with large tip catheter and Lasso cat heter (Cordis) and focal ablation was performed at the site of the earliest acti vation within pulmonary veins,or pulmonary vein isolation was achieved by multip le sites ablation limited to the ostial site with the earliest pulmonary vein p otentials if the patient had nonsustained AT.No APB and AT after ablation w ere t he procedure endpoint.Results:Atrial tachyarrhythmias were originated from right superior (8 case),left superior (5 cases) and left inferior (1 cases) pulmonary vien.Focal ablation or pulmonary vein isolation was performed in 10 and 4 patie nts respectively.Endpoint was achieved in all patients after focal or isolation ablation.One patients had AT recurrence during follow up.It is concluded that r adiofrequency ablation is a important method to treat APB and AT originating fro m pulmonary veins.[ Chinese Journal of Cardiac Pacing and Electrophysiology, 2003,17(1):31～34]

关 键 词：电生理学 导管消融 射频电流 肺静脉 房性心律失常 

分 类 号：R454.1[医药卫生—治疗学] R541.7[医药卫生—临床医学]