持续性心房颤动经导管射频消融治疗的方法探讨(附三例报告)

探讨经导管射频消融治疗持续性心房颤动 (简称房颤 )的可行性。 3例房颤患者房颤持续时间 2个月至 1年4个月。术前口服胺碘酮 ,1例转为窦性心律伴频发房性早搏 (简称房早 ) ,1例转为房早与短阵房颤和阵发心房扑动 (简称房扑 ) ,1例转为房早与阵发房性心动过速 (简称房速 )。经导管作点状消融或点状消融加房扑线性消融 ,2例术中房早消失 ,1例房早显著减少 ,经快速心房刺激或静脉点滴异丙肾上腺素均不能诱发房颤。 1例术后有短阵房颤发作 ,服用莫雷西嗪 ,房颤未再发作。结论 :某些持续性房颤用药物后可转复成窦性心律伴频发房早、房扑或房速 ,局部单点消融或单点消融加线性消融可以达到治疗目的。

Radiofrequency Catheter Ablation for the Treatment of Sustained Atrial Fibrillation.

This study tested the feasibility of radiofrequency (RF) catheter ablation in the treatment of sustained atrial fibrillation (AF).Three patients with sustained atrial fibrillation (lasted from two months to one year and four months) underwent electrophysiologic study and catheter ablation.Before procedure,amiodarone was used to convert AF to either sinus rhythm and frequent premature atrial complexes (PAC,2 patients) or sustained atrial flutter and atrial tachycardia (1 patient).Focal ablation or focal plus linear ablation were performed targeting at PAC or atrial flutter and tachycardia.PACs disappeared during procedure in two cases.PACs reduced significantly in one case.Short runs of AF occurred in one case after abltion,but it can be controlled by oral moricizine.Conclusion:Focal ablation or focal plus linear ablation is feasible to treat some patients with sustained AF,which can be converted to sinus rhythm with PACs or atrial flutter and atrial tachycardia by oral Amiodarone.