导管射频消融右侧房室旁道的方法学评价

对接受导管射频消融治疗的５４ 例致心律失常性右侧显性房室旁道病人进行回顾性分析。比较不同部位旁道的消融参数发现，游离壁和前间隔旁道组心室波提前度多、ＡＶ 比值较小、房性早搏较多和消融能量较大，中和后间隔旁道组心房波振幅较高、ＡＶ 比值较大、导管较稳定和能量较小；比较试消融成功和不成功的放电参数发现，试消融成功者心室波的提前度、心房波的振幅、导管的稳定性和消融能量均优于消融不成功者，而且旁道阻断时间越短者其心室波提前度越大、心房波振幅越高、ＡＶ 比值越大、导管越稳定。我们认为影响右侧显性房室旁道消融成功率的主要因素是导管操作经验和对靶点图的识别。

Methodological Evaluation of Radiofrequency Catheter Ablation Used in Patient with Arrhythmiogenic Right Atrioventricular Accessory Pathway

Consecutive fifty-four patients with arrhythmogenic right accessory pathway (AP) treated by radiofrequency catheter ablation were analyzed retrospectively. By comparing the ablation parameters of differentAPs, we found in free wall and anterior septumgroup there were earlier ventricular wave (V), smaller atrioventricular wave (AV) ratio, more atrial premature beats and higher ablation energy; in middle and posterioe septum group there were higher atrial amplitude, larger AV ratio, more stable catheter position and lower ablation energy. By comparing the parameters of success and failure energy delivery, we found that in success ablation groupthere were earlier V wave, higher atrial amplitude, more stable catheter ablation and lower ablation energy. The quicker the AP ablated, the earlier V wave, higher atrial amplitude, larger AV ratio and more stable catheter position.We conclude that the main factors infect the successful ablation of right manifest AP are catheter operative experiences and the recognization the target electrogram.