CAJ | 학술논문

目的：评价Mahaim纤维介导心动过速的电生理特点和射频消融治疗的有效性和安全性。方法回顾性分析中国医科大学附属盛京医院心内科2005年3月至2014年1月诊断的34例Mahaim纤维患者的电生理特点。采用在三尖瓣环上标测Mahaim纤维电位或标测最早心室激动波，或者在机械操作损伤旁路传导部位进行靶点的标测，进而消融治疗Mahaim纤维旁路。结果所有病例均消融成功。25例标测到Mahaim纤维电位。6例在三尖瓣环附近最早心室激动点进行消融。3例在标测过程中出现一过性旁路传导功能中断处消融。30例靶点分布于三尖瓣环8～10点范围内，4例位于右前侧壁和右后间隔。结论根据Mahaim纤维的电生理特点，选择相应的标测方法，可以提高消融治疗成功率。
목적：평개Mahaim섬유개도심동과속적전생리특점화사빈소융치료적유효성화안전성。방법회고성분석중국의과대학부속성경의원심내과2005년3월지2014년1월진단적34례Mahaim섬유환자적전생리특점。채용재삼첨판배상표측Mahaim섬유전위혹표측최조심실격동파，혹자재궤계조작손상방로전도부위진행파점적표측，진이소융치료Mahaim섬유방로。결과소유병례균소융성공。25례표측도Mahaim섬유전위。6례재삼첨판배부근최조심실격동점진행소융。3례재표측과정중출현일과성방로전도공능중단처소융。30례파점분포우삼첨판배8～10점범위내，4례위우우전측벽화우후간격。결론근거Mahaim섬유적전생리특점，선택상응적표측방법，가이제고소융치료성공솔。
Objective To evaluate the efficacy and safety of radiofrequency ablation on reentry tachycardia mediated by Mahaim fiber.Methods 34 patients, who were diagnosed as antidromic atrioventricular reciprocating tachycardia attributed to atriofascicular pathways, underwent electrophysiological exam and ablation in Shengjing Hospital at China Medical Uni-versity since March 2005.The Mahaim fiber potential or earliest ventricular activation recorded around the tricuspid valve was considered as ideal ablation target.If the accessory pathway conduction was interrupted by the mechanical bump, abla-tion was applied at the bump site.Results All the patients were successfully ablated.Mahaim fiber potential was identified in 25 patients.Ablation was applied at earliest ventricular activation site in 6 patients, and in 3 patients at bump site where leaded to transient accessory pathway conduction interruption.The target sites were located at right lateral wall around tri-cuspid valve in 30 patients, the other 4 target sites at right anterior lateral wall or right posterior septal wall.Conclusion Reentry tachycardia mediated by Mahaim fiber can be successfully ablated according to its electrophysiological properties.