超高龄阵发性室上性心动过速患者的射频导管消融研究

目的探讨超高龄患者阵发性室上性心动过速射频导管消融（下称消融）的有效性和安全性。方法对11例80岁以上的超高龄阵发性室上性心动过速患者采用常规方法消融治疗。结果先行冠状动脉造影术2例。因髂动脉迂曲选择对侧动脉或使用长血管鞘跨过迂曲部位消融成功4例。术中发生心力衰竭1例，在导管操作及电生理检查中诱发心房颤动、房性心动过速5例。主动脉瓣狭窄应用直接穿间隔法后消融1例。在放电时出现二度房室传导阻滞1例，一度房室传导阻滞2例。穿刺点出现血肿1例。11例首次消融均成功。术后随访24个月均未复发，也无传导阻滞等严重并发症发生。结论超高龄阵发性室上性心动过速患者采用消融治疗安全有效，但根据不同个体电生理特点需制定不同的治疗方案。

Radiofrequency Catheter Ablation in Very Old Patients with Paroxysmal Superventricular Tachycardia

Objective To evaluate the efficacy and safety of radiofrequency catheter ablation (RFCA) in very old patients with paroxysmal supraventricular tachycardia (PSVT). Methods 11 patients (over 80 years of age) with PSVT underwent RFCA. Results RFCA was successful in all patients. 2 cases underwent coronary angiography before RFCA.A long sheath or contralateral iliac artery was chosen in 4 cases for iliac artery tortuosity. Heart failure occurred in one case, atrial fibrillation and atrial tachycardia in 5 cases during the procedure. RFCA was performed by transseptal approach in one case for aortic valve stenosis. First degree atrioventricular block occurred in 2 cases and second degree in one case during delivery of energy. Hematoma at puncture site occurred in one case. There was no serious complication and recurrence during 24-month follow-up. Conclusion RFCA is effective and safe for very old patients with PSVT, but individual strategy is needed.