肺静脉口点状消融治疗局灶性心房颤动  

Foci-linear radio-frequency ablation on Orifices of pulmonary to treat vein focal atrial fibrillation

作　　者：陈国方 陈晓敏[2] 江隆福 叶红华[2] 刘旭[3] 

机构地区：[1]浙江省宁波第二医院,15000 [2]浙江省宁波市第一医院,315010 [3]上海胸科医院,200433

出　　处：《浙江临床医学》2004年第1期10-11,共2页Zhejiang Clinical Medical Journal

摘　　要：目的 报道2例成功消融的阵发性局灶性心房颤动 (房颤 )。方法 男性 ,48岁 ,阵发性心悸1年余 ,女性 ,53岁 ,阵发性心悸半年余 ,均诊断为特发性房颤。24h动态心电图发现频发房早及由房早触发的房颤。放置6F多极导管电极于右室、His束及冠状静脉窦 ,置6Fpigtail造影管于肺动脉 ,行肺动脉造影 ,显示双侧上肺静脉开口。两次房间隔穿刺 ,将两根8Fswartz鞘管送入左房 ,经鞘管送入肺静脉环状多极电极 (Lasso)于左上、下肺静脉口、右上肺静脉口周围。标测到肺静脉电位 (PVP) ,普遍温控可操纵大头消融电极于PVP最明显处温控法 (55～60℃ )放电。结果 消融成功 ,PVP消失。随访2.5个月无房颤发作。结论 采用肺静脉口点消融是治疗局灶性房颤的安全有效方法。Objective To report two cases of paroxysmal focal atrial fi br illation treated with Radiofrequency ablation. Methods Case1:male,48,paroxysm al palpitation for one year;case2:female,53,paroxysmal palpitation for half a y ear.Both diagnoses were(Idiopathic atrial fibrillation.Frequent atrial prematur e beat by which the AF was induced was found in both cases by24h Holter monitori ng electrocardiogram.6F multipolar electrode catheters were adjusted at appropri ate position to record the electrogram of right ventricle,bundle of His and Cor onary venous sinus.Orifices of superior pulmonary vein were manifested by Pulmon ary arteriography.During the procedure,Lasso electrode catheter were placed at t he left and right superior pulmonary veins and left inferior pulmonary vein resp ectively through the8F swartz sheaths by twice interatrial septum puncture.After pulmonary vein potential(PVP)was mapped at the onset of atrial fibrillation, placed the tip of thermistor ablation catheter on locality PVP existed,then the radiofrequency energy was delivered and tip-tissue temperature were controlled w ithin55-60℃. Results Radiofrequency ablation was successful and the PVP vanˉi shed.During a follow-up of2.5months,there was no recurrence found in the patien ts. Conclusions Point radiofrequency ablation on orifice of pul-monary vein fo r focal atrial fibrillation is effective and safe.

关 键 词：肺静脉 点状消融 治疗 局灶性心房颤动 临床资料 

分 类 号：R541.7[医药卫生—心血管疾病]