房性心动过速的导管射频消融术治疗

目的:探讨房性心动过速(房速)行导管射频消融术(RFCA)治疗方法、疗效及其安全性。方法:选择24例经心内电生理检查证实为房速并同意行RFCA治疗患者,常规电生理检查分别在高位右房(HRA)、右室心尖部(RVA)2个部位行S1S1刺激和程控期前收缩刺激,记录房速的诱发和终止方式。靶点标测采用激动标测法,单根消融导管于右房或左房(经房间隔穿刺)内标测寻找最早心房激动或用多极导管作为参考电极,再用大头导管寻找消融靶点。根据消融结果,分析房速的起源部位、消融即时成功率、并发症、复发原因以及X线曝光时间等。结果:24例房速患者中,22例(88%)右房房速,3例(12%)左房房速(1例患者同时存在左、右房2个部位房速)。4例与其他心律失常合并存在,1例房室结折返性心动过速,1例合并房性折返性心动过速,1例合并心房颤动,1例同时合并心房扑动和心房颤动。24例患者均完成射频消融治疗(实际消融25例次),均采用温控消融,按预定消融终点,23例次即时消融成功,即时成功率92%(23/25),平均X线曝光时间(32±6.4)min,消融失败2个病例中,右房房速和左房房速各1例,再次消融成功。未发生房室传导阻滞、心包填塞等严重并发...

Retrospective study on clinical treatment of atrial tachycardia by radiofrequency catheter ablation

Objective:To investigate the methods,efficacy and safety of clinical treatment of atrial tachycardia(AT) by radiofrequency catheter ablation(RFCA),and to make prospect on the new therapic way.Method:Intracardiac electrophysiologic study(EPS) and RFCA were performed in consecutive 24 patients with AT.The induc-tive and terminative condition were recorded.Mapping techniques were based on identification of the earliest endocardial atrial electrogram recorded during AT with one large-tipped catheter or multipol...