主动脉无冠窦内射频消融前间隔房室旁路

目的 报道经主动脉无冠窦内射频消融前间隔房室旁路.方法 7例患者,男性4例,女性3例,平均年龄（38.4±14.7）岁.电生理检查证实存在房室旁路,并检查其前传逆传功能和诱发旁路参与的房室折返性心动过速.在心动过速时标测最早心房逆传激动点作为消融靶点.结果 7例心动过速时最早心房激动部位均位于前间隔区域,但经右心房途径反复消融均不能成功阻断旁路,而在无冠窦内可标测到最早逆传心房激动点并消融成功,无并发症出现.结论 主动脉无冠窦内消融可作为治疗前间隔房室旁路的一种新途径,特别适用于右心房前间隔区域消融失败的病例.

Radiofrequency catheter ablation of anteroseptal accessory pathway in the noncoronary aortic sinus cusp

Objective To report successful catheter ablation of anteroseptal accessory pathway (AP)from the noncoronary aortic sinus cusp. Methods Seven patients4 male,mean age(38. 4 ± 14. 7)years] were included. Electrophysiology tests were conducted to verify the antegrade and retrograde conduction of the pathway and to induce the atrioventricular reentrant tachycardia (AVRT) mediated by the pathway. The earliest retrograde atrial activation site during tachycardia was mapped and ablated in right atrial and noncoronary aortic sinus cusp. Results In all 7 patients, the earliest retrograde atrial activation during tachycardia were recorded in the His-bundle region, multiple radiofrequency ablation application were delivered at the anteroseptal region of right atria, but failed to block the conduction of AP. However, the earliest atrial activation during tachycardia was also recorded in the noncoronary sinus cusp, and the anteroseptal AP was successfully blocked by ablation in the noncoronary sinus cusp without complications. Conclusion Mapping and ablation of an anteroseptal AP in the noncoronary sinus cusp may provide an alternative approach in patients, especially when ablation was failed in the anteroseptal region of right atria.