射频消融术后束支阻滞发生机制的探讨

目的探讨射频消融术后出现束支阻滞的发生机制。方法回顾性分析10例显性预激综合征患者射频消融术后出现束支阻滞的临床资料。结果10例心电图改变为A型预激合并右束支阻滞5例；A型预激合并左柬支阻滞1例；B型预激合并右束支阻滞2例；其余2例A型预激合并右束支阻滞为射频消融术中的机械性损伤造成。结论旁路与束支阻滞位于同侧时，束支阻滞的心电图特征可被掩盖；旁路与束支阻滞位于异侧时，束支阻滞的心电图特征一般不会被掩盖，但并非绝对，这可能与旁路附着心室的部位有关。

The study of mechanism of bundle branch block induced after radiofrequency ablation

Objective To investigate the mechanism of bundle branch block induced after radiofrequency ablation. Methods The clinic data of 10 cases with dominant WPW syndrome and bundle branch block induced after radiofrequency ablation . were analyzed. Results The changes of electrocardiogram showed A-WPW syndrome and RBBB have coexistence in 5 cases ; A-WPW syndrome and LBBB have coexistence in 1 case ; B-WPW syndrome and RBBB have coexistence in 2 cases ; A-WPW syndrome and RBBB which is produced by mechanic injury during radiofrequency ablation have coexistence in 2 cases. Conclusion When accessory pathway and bundle branch block were located in the same side, the characteristics of bundle branch block in electrocardiogram were covered ; when accessory pathway and bundle branch block were located in the different side , the characteristics of bundle branch block in electrocardiogram were usually not covered. It may relate to accessory pathway linking ventricular position.