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射频消蚀是治疗预激综合征的新方法,影响成功率的关键是旁道定位。1991年10月我们以旁道电位为标志成功地消蚀1例,报告如下。 病例介绍: 患者 男性,21岁。主因反复发作心悸、胸闷12年入院。静态心电图示A型预激综合征,发作时为室上性心动过速,最快心率250次/分,持续数小时至数天不等,静注心律平可缓解。乎均每年发作2次以上。入院后常规体检、X线胸片及超声心动图均无异常。术前禁食8小时,术前半小时留置导尿管。按常规方法穿刺左股静脉送入2根6F四极导管,分别置于高右房及希氏束。将另一导管经右股静脉送入右室尖部。穿刺左锁骨下静脉,送入一根7 F Jackman电极导管至冠状窦。该导管末端有三组电极呈正交分布,每组电极有4个,绕导管一周。穿刺右股动脉送入7F大头消蚀导管(Mansfield/Webster)至二尖瓣环左室侧。消蚀导管插入后静注肝素5 000单位,以后每小时静注2 000单位。
Radiofrequency ablation is a new method for the treatment of Wolff-Parkinson-White syndrome. The key to the success rate is to locate the sidepath. In October 1991, we successfully eradicated one case with the bypass potential as the following report. Case description: Patient male, 21 years old. Mainly due to recurrent heart palpitations, chest tightness 12 years admitted. Static ECG shows type A WPW syndrome, onset of supraventricular tachycardia, the fastest heart rate of 250 beats / min, lasting several hours to several days, intravenous injection of rhythm can be alleviated. Almost all episodes of more than 2 times per year. After admission, physical examination, X-ray and echocardiography were normal. Preoperative fasting 8 hours, half an hour before catheter indwelling catheter. According to the conventional method of puncture the left femoral vein into the two 6F quadrupole catheter, respectively, placed in the high right room and His bundle. The other catheter through the right femoral vein into the right ventricular tip. Puncture the left subclavian vein into a 7 F Jackman lead to the coronary sinus. The end of the catheter has three groups of electrodes are orthogonal distribution, each electrode has four, around the catheter a week. The right femoral artery was punctured into the 7F cannula (Mansfield / Webster) to the left ventricular side of the mitral annulus. Heparin 5 000 units will be injected intravenously after ablation catheterization and 2 000 units intravenously thereafter.