窦房折返性心动过速的射频消融治疗(附二例报告)

报道２例窦房折返性心动过速（ＳＮＲＴ）的电生理特点及射频消融结果。男、女各１例，两例患者心动过速发作时体表心电图１２导联Ｐ波形态与窦性心律时相同，心内电生理检查证实为ＳＮＲＴ。采用激动顺序标测，心动过速发作时于右房高侧壁记录到心房最早激动，且与窦性心律时激动顺序相同，成功消融靶点部位Ａ波分别早于体表心电图Ｐ波５０和３０ｍｓ。以１５～３０Ｗ输出功率消融６０～１２０ｓ均成功。随访２～６个月无心动过速发作，窦房结功能正常。比较有效消融和无效消融的靶点特征，提示提前、增宽及碎裂的Ａ波可作为消融靶点。根据笔者初步经验认为射频消融治疗ＳＮＲＴ是安全有效的。

Radiofrequency Current Ablation of Sinoatrial Node Reentrant Tachycardia:Two Cases Report

Two patients with sinoatrial node reentrant tachycardia (SNRT) underwent electrophysiologic study and radiofrequency catheter ablation.P wave configuration on 12lead electrocardiogram during tachycardia was similar to that in sinus rhythm.They were found to have inducible sustained SNRT by electrophysiologic study.During tachycardia,earliest atrial activation sequence origination from the high lateral right atrium was similar to that in sinus rhythm.Earliest atrial activation had timing relative to the surface P wave by -50 ms and -30 ms,respectively.Successful ablation site characteristics during SNRT included earliest atrial activation and significantly prolonged and fractioned electrograms.Radiofrequency energy (15 to 30 W) was delivered to the target sites through the ablation catheter for 60 to 120 seconds.Ablation was successful in both.Patients were fellowed up 2 to 6 months,and there have been no recurrences.It is considered that SNRT may be effectively and safely treated with radiofrequency