论文部分内容阅读
目的 总结应用改进的标测和消融方法以及新技术治疗儿童快速心律失常的经验。方法 ①Swartz长鞘 :在 35例右侧旁道、慢径路、房性心动过速 (局灶性 +折返性 )和房扑消融中应用。②参考电极 :右室流出道和右室流入道分别放置 2根电极 ,采用“蛙跳”方法标测较早的心室激动点 ,然后用射频导管在该点附近标测。③在窦性心律时在左室间隔部记录到较局部室波提前的高频低幅电位激动晚于希氏束电位 2 0ms以上处为靶点消融左室特发性室速。④应用CARTO系统治疗 :3例AT(局灶性 +折返性 )、1例AF和 1例ILVT。结果 40例患儿均成功消融 ,放电次数和透视时间分别为 (5 0± 3 8)次和 (2 5± 12 4)min。结论 改进的标测和消融方法以及新技术的应用 ,减少放电次数 ,缩短X线透视时间 ;尤其CARTO系统的应用解决以往的难题。
Objective To summarize the experience of using improved mapping and ablation methods and new techniques in the treatment of tachyarrhythmia in children. Methods ①Swartz long sheath: in 35 cases of right side access, slow path, atrial tachycardia (focal + reentry) and atrial flutter ablation. ② reference electrode: the right ventricular outflow tract and right ventricular influx were placed two electrodes, using “frog jump” method of mapping the early ventricular activation point, and then radio frequency catheter in the vicinity of the mapping. ③ sinus rhythm in the left ventricular septal record than the local premature ventricular wave amplitude of the high-frequency low-amplitude potential stimulation later than the His bundle potential of more than 2 0ms at the target ablation of left ventricular idiopathic VT. The application of CARTO system: 3 cases of AT (focal + reentry), 1 case of AF and 1 case of ILVT. Results All the 40 cases were successfully ablated. The number of discharges and fluoroscopy time were (50 ± 3 8) and (2 5 ± 12 4) min, respectively. Conclusion Improved mapping and ablation methods and the application of new technologies reduce the number of discharges and shorten the X-ray fluoroscopy time; especially the application of CARTO system solves the previous problems.