中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
5期
377-381
,共5页
居维竹%陈明龙%杨兵%张凤祥%陈红武%余金波%顾凯%单其俊%邹建刚
居維竹%陳明龍%楊兵%張鳳祥%陳紅武%餘金波%顧凱%單其俊%鄒建剛
거유죽%진명룡%양병%장봉상%진홍무%여금파%고개%단기준%추건강
心动过速,阵发性%心动过速,室上性%导管消融术
心動過速,陣髮性%心動過速,室上性%導管消融術
심동과속,진발성%심동과속,실상성%도관소융술
Tachycardia,paroxysmal%Tachycardia,supraventricular%Catheter ablation
目的 报道与冠状静脉窦肌袖相关的左侧心外膜旁道的射频消融经验及旁道定位、电生理特征.方法 回顾性分析2009年1月至2011年7月共721例左侧旁道消融资料,17例[男性11例,平均年龄(37±17)岁]至冠状静脉窦内消融(2.4%),而如果除外其中6例外院失败病例,则发生率仅为1.5%.结果 17例左侧心外膜旁道中,11例位于心中静脉,余6例位于二尖瓣环侧后壁.少数心中静脉旁道可存在憩室.所有病例均消融成功,放电开始至旁道阻断时间平均为1.1 ~10.0(4.7±2.7)s.多数病例在靶点可记录到较明显的旁道电位(10例).平均随访(21±16)个月,有1例心中静脉内旁道在3个月时复发,再次入院行消融成功,其余患者无复发.所有患者均无并发症发生.结论 约1.5%~2.4%的左侧旁道可与冠状静脉窦肌袖相连接需要至冠状窦内消融,其中多数位于心中静脉,少数位于冠状静脉窦后侧壁.体表心电图Ⅱ导联负向“△”波对心中静脉旁道预测率为100%.经冠状静脉窦心外膜消融安全可行,远期成功率较高.
目的 報道與冠狀靜脈竇肌袖相關的左側心外膜徬道的射頻消融經驗及徬道定位、電生理特徵.方法 迴顧性分析2009年1月至2011年7月共721例左側徬道消融資料,17例[男性11例,平均年齡(37±17)歲]至冠狀靜脈竇內消融(2.4%),而如果除外其中6例外院失敗病例,則髮生率僅為1.5%.結果 17例左側心外膜徬道中,11例位于心中靜脈,餘6例位于二尖瓣環側後壁.少數心中靜脈徬道可存在憩室.所有病例均消融成功,放電開始至徬道阻斷時間平均為1.1 ~10.0(4.7±2.7)s.多數病例在靶點可記錄到較明顯的徬道電位(10例).平均隨訪(21±16)箇月,有1例心中靜脈內徬道在3箇月時複髮,再次入院行消融成功,其餘患者無複髮.所有患者均無併髮癥髮生.結論 約1.5%~2.4%的左側徬道可與冠狀靜脈竇肌袖相連接需要至冠狀竇內消融,其中多數位于心中靜脈,少數位于冠狀靜脈竇後側壁.體錶心電圖Ⅱ導聯負嚮“△”波對心中靜脈徬道預測率為100%.經冠狀靜脈竇心外膜消融安全可行,遠期成功率較高.
목적 보도여관상정맥두기수상관적좌측심외막방도적사빈소융경험급방도정위、전생리특정.방법 회고성분석2009년1월지2011년7월공721례좌측방도소융자료,17례[남성11례,평균년령(37±17)세]지관상정맥두내소융(2.4%),이여과제외기중6예외원실패병례,칙발생솔부위1.5%.결과 17례좌측심외막방도중,11례위우심중정맥,여6례위우이첨판배측후벽.소수심중정맥방도가존재게실.소유병례균소융성공,방전개시지방도조단시간평균위1.1 ~10.0(4.7±2.7)s.다수병례재파점가기록도교명현적방도전위(10례).평균수방(21±16)개월,유1례심중정맥내방도재3개월시복발,재차입원행소융성공,기여환자무복발.소유환자균무병발증발생.결론 약1.5%~2.4%적좌측방도가여관상정맥두기수상련접수요지관상두내소융,기중다수위우심중정맥,소수위우관상정맥두후측벽.체표심전도Ⅱ도련부향“△”파대심중정맥방도예측솔위100%.경관상정맥두심외막소융안전가행,원기성공솔교고.
Objective To report the single-center clinical experience of catheter ablation of epicardial accessory pathway associated with coronary sinus musculature.Methods The data of 721 cases of left sided accessory pathway ablation were retrospectively analyzed.Ablation in the coronary sinus was performed in 17 (2.4 %) cases [11 males,mean age(37 ± 11) years].Results Among the 17 cases,the accessory pathway was successfully ablated in middle cardiac vein and posterior lateral coronary sinus in 11 and 6 cases,respectively.Deverticulum of middle cardiac vein was seen in 2 cases.Mean time required to block the accessory pathway was (4.7 ± 2.7) s.An accessory pathway potential could be recorded at the target site in 10 out of 17 patients (59%).During a mean (21 ± 16) months follow up,only one patient experienced recurrence who was successfully cured by a second ablation session.No procedure related complication was reported.Conclusion About 2.4% of left accessory pathway may have epicardial connection locating at middle cardiac vein or lateral part of the coronary sinus and require epicardial ablation.The epicardial ablation is safe and effective,warrants an excellent long-term results.