希氏束旁旁路的射频消融

目的探讨希氏束旁旁路射频的可行性和安全性。方法10例心内电生理检查确诊为希氏束旁旁路患者,其中显性旁路3例,隐性旁路7例。窦律下采用能量滴定法温控消融,从小功率(10W)短时间(5s)开始。结果10例患者除2例担心手术风险拒绝消融治疗外,余8例全部行射频消融治疗并获得成功。温度55~60℃,功率平均26.7±11.9W,消融时间60s,重复诱发无心动过速,术后随访3~6月无复发。结论窦律下消融希氏束旁旁路,是安全有效的。但应从小功率短时间开始,严密心电监护下进行。

Radiofrequency Catheter Ablation of Para-His Accessory Pathway

Objective To investigate the safety and feasibility of radiofrequency catheter ablation of Para-His accessory pathway.Methods During January,2005 to December,2005,ten patients were diagnosed as Para-His Accessory Pathway(AP) by intracardiac electrophysiologic study.Among them,manifested AP 3 cases,concealed AP 7 cases.The APs were ablated with low power(10w) and in short interval(5s).They employed temperature controlled ablation with energy titration under sinus rhythm.Results Two of ten patients refused ablation because of afraid of high operation risk.All radiofrequency catheter ablations of the eight patients were successful,temperature 55～60℃,power 26.7+11.9w,time 60s,and none was recurred after 3～6 months follow up.Conclusions Radiofrequency catheter ablation of Para-His accessory pathway under sinus rhythm is safe and feasible.But the procedure should be conducted with low power and for a short time at the beginning,and should be under close monitoring.