论文部分内容阅读
经导管射频消融治疗15例阵发性室上性心动过速(PSVT)患者。宽QRS心动过速1例,同时有宽及窄QRS心动过速1例,单纯窄QRS心动过速13例。显性预激6例,其中A型预激4例,B型预激2例,12例为单一旁道,1例为房室结4径路所引起的慢-快型房室结折返性心动过速(AVNRT),1例为3条旁道,1例为2条旁道同时合并有房室结双径路所引起的慢-快型AVNRT。17条旁道的部位分布如下:右前间隔1条,右中间隔3条,右后间隔4条,左后间隔3条,左游离壁2条,右正后游离壁2条,右后外游离壁1条,右前游离壁1条。射频治疗后17条旁道的前传及逆传全部阻断,2条旁道并有房室结双径路病人的2条旁道均阻断,其房室结双径路的前传快径与逆传快径亦被阻断,房室结4径路病人的3条慢径中的1条阻断,在用异丙肾的条件下全部病人均不能诱发心动过速。手术时间为2-8b,平均4b。放电次数2-40次,平均19次,右侧旁道占71.0%,多旁道占13.0%,射频成功率为100%,无严重并发症。
Transcatheter RFA for 15 patients with paroxysmal supraventricular tachycardia (PSVT). 1 case of wide QRS tachycardia, while wide and narrow QRS tachycardia in 1 case, simple narrow QRS tachycardia in 13 cases. Six cases were dominant pre-excitation, including 4 cases of type A pre-excitation, 2 cases of type B pre-excitation, 12 cases of single bypass and 1 case of slow-fast atrioventricular nodal reentrant cardioversion caused by atrioventricular node 4 pathways (AVNRT), 1 case of 3 bypass, 1 case of 2 bypass concurrent with atrioventricular node dual pathways caused by slow - fast AVNRT. The distribution of the 17 accessory pathways is as follows: 1 anterior right, 3 anterior middle, 4 anterior right, 3 anterior left, 2 left anterior wall, 2 anterior right posterior free wall, 1 wall, 1 free wall right front. Radiofrequency treatment of 17 bypass pre-pass and reverse all blocked, 2 bypass and atrioventricular node dual pathways in patients with two bypass were blocked, the AV channel anterior fast pathway and reverse transmission Fast track was also blocked, a pathway in the atrioventricular node 4 pathways blocked by one of three slow pathway, all patients under the condition of isoproterenol can not induce tachycardia. Surgery time is 2-8b, with an average of 4b. The number of discharges was 2-40 times, with an average of 19 times. The right side access accounted for 71.0%, the multi-side access 13.0% and the radio frequency success rate was 100% without serious complications.