索他洛尔在房室旁道射频消融术中的应用

目的探讨索他洛尔在房室旁道射频消融(RFCA)术中的应用。方法18例旁道患者在常规电生理检查后顿服索他洛尔160mg,分别于服药后30、60、90、120和150min重复测量各项电生理参数。结果服药前后心房(A)、心室(V)、房室结(AVN)、旁道前传(APa)、旁道逆传(APr)有效不应期(ERP)分别为(211±24)msvs(243±36)ms、(205±11)msvs(242±28)ms、(269±48)msvs(343±97)ms、(263±45)msvs(400±160)ms、(232±37)msvs(298±50)ms(P<0.05)。无1例旁道阻断。窦房结恢复时间(SNRT)、窦性周长(SCL)分别为(1165±209)msvs(1456±371)ms、(724±116)msvs(996±178)ms(P<0.05)。3例房颤服药后不再诱发,2例心内电刺激难以终止的房室折返性心动过速(AVRT)服药后自行终止于房室结前传。18例患者均消融成功,随访7～18个月,无1例复发。结论索他洛尔显著延长心脏ERP,但不影响旁道的RFCA,能够预防或抑制RFCA术中导管和电刺激诱发的房颤,方便了手术操作。

The application of Sotalol on atrioventricular radiofrequency accessory_ catheter ablation (RFCA)

Objective To explore the application of Sotalol on atrioventricular accessory pathway in the radiofrequency catheter albation.Methods The18patients with atrioventricular accessory pathway were studied,160mg of Sotalol was orally administered and intracardiac electrophysiologi-cal study was performed after the administration every30minutes for five times.Results The electrophysiological data before and after the Sotalol administration were:Arial ERP(211±24)ms vs(243±36)ms (P<0.05);Ventricular ERP(205±11)ms vs(242±28)ms (P<0.05);Anterograde ERP of the atri-oventricular node(269±48)ms vs(343±97)ms (P<0.05);Anterograde REP of the accessory pathway(263±45)ms vs(400±160)ms (P<0.05);Retrograde ERP of the accessory pathway(232±37)ms vs(298±150)ms (P<0.05);Sinus nodal recovery time (SNRT)(1165±209)ms vs(1456±37)ms (P<0.05);Sinus cycle-length(SCL)(724±116)ms vs(996±178)ms (P<0.05).Three patients with atrial fibrillation were not in-duced by atrial electrical stimulation after the administration of Sotalol30minutes later.Two cases of induced atrioventricular reentrant tachycardia(AVTR),which is not successful to rapid electrical stimulation before Sotalol administration,were automatically determined or easily deter-mined by electrical stimulation after the administration of Sotalol30minuts later.Conclusion So-talol(160mg)orally administered can increase the ERP of the accessory pathway in both an-terograde and retrograde conduction,but dose not block the conduction of the accessory pathway.It can prevent or restain the atrial fibrillation induced by electrical stimulation and promote the rapid electrical stimulation effects on AVRT.So the Sotalol can be used in the radiofre-quency catheter ablation(RFCA)of AVRT for preventing atrial fibrillation and increasing the tolerance